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单一和多发性道路交通伤结局的影响因素比较:中国上海的一项区域研究(2011 - 2014年)

Comparison of influencing factors on outcomes of single and multiple road traffic injuries: A regional study in Shanghai, China (2011-2014).

作者信息

Yu Wenya, Chen Haiping, Lv Yipeng, Deng Qiangyu, Kang Peng, Zhang Lulu

机构信息

Department of Military Health Service Management, College of Military Health Service Management, Second Military Medical University, Shanghai, China.

出版信息

PLoS One. 2017 May 11;12(5):e0176907. doi: 10.1371/journal.pone.0176907. eCollection 2017.

Abstract

INTRODUCTION

To identify key intervention factors and reduce road traffic injury (RTI)-associated mortality, this study compared outcomes and influencing factors of single and multiple road traffic injuries (RTIs) in Shanghai.

METHODS

Based on the design of National Trauma Data Bank, this study collected demographic, injury, and outcome data from RTI patients treated at the four largest trauma centers in Shanghai from January 2011 to January 2015. Data were analyzed with descriptive statistics, univariate analysis, and hierarchical logistic regression analysis.

RESULTS

Among 2397 participants, 59.4% had a single injury, and 40.6% had multiple injuries. Most patients' outcome was cure or improvement. For single-RTI patients, length of stay, body region, central nervous system injury, acute renal failure, multiple organ dysfunction syndrome, bacterial infection, and coma were significantly related to outcome. For multiple-RTI patients, age, admission pathway, prehospital time, length of stay, number of body regions, body region, injury condition, injury severity score, and coma were significantly related to outcome.

CONCLUSIONS

Emergency rescue in road traffic accidents should focus on high-risk groups (the elderly), high-incidence body regions (head, thorax, pelvis) and number of injuries, injury condition (central nervous system injury, coma, complications, admission pathway), injury severity (critically injured patients), and time factors (particularly prehospital time).

摘要

引言

为了确定关键干预因素并降低道路交通伤害(RTI)相关死亡率,本研究比较了上海市单发性和多发性道路交通伤害(RTIs)的结果及影响因素。

方法

基于国家创伤数据库的设计,本研究收集了2011年1月至2015年1月在上海四家最大创伤中心接受治疗的RTI患者的人口统计学、损伤和结果数据。采用描述性统计、单因素分析和分层逻辑回归分析对数据进行分析。

结果

在2397名参与者中,59.4%为单发性损伤,40.6%为多发性损伤。大多数患者的结果是治愈或好转。对于单发性RTI患者,住院时间、身体部位、中枢神经系统损伤、急性肾衰竭、多器官功能障碍综合征、细菌感染和昏迷与结果显著相关。对于多发性RTI患者,年龄、入院途径、院前时间、住院时间、身体部位数量、身体部位、损伤情况、损伤严重程度评分和昏迷与结果显著相关。

结论

道路交通事故的紧急救援应关注高危人群(老年人)、高发病身体部位(头部、胸部、骨盆)和损伤数量、损伤情况(中枢神经系统损伤、昏迷、并发症、入院途径)、损伤严重程度(重伤患者)以及时间因素(尤其是院前时间)。

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