创伤机制可预测钝性创伤患者的损伤频率和严重程度。

Trauma mechanism predicts the frequency and the severity of injuries in blunt trauma patients.

作者信息

Parreira José Gustavo, Rondini Giovanna Zucchini, Below Cristiano, Tanaka Giuliana Olivi, Pelluchi Julia Nunes, Arantes-Perlingeiro Jacqueline, Soldá Silvia Cristine, Assef José César

机构信息

Irmandade da Santa Casa de Misericórdia de São Paulo, Serviço de Emergência, São Paulo, SP, Brasil.

Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Cirurgia, São Paulo, SP, Brasil.

出版信息

Rev Col Bras Cir. 2017 Jul-Aug;44(4):340-347. doi: 10.1590/0100-69912017004007.

DOI:10.1590/0100-69912017004007

PMID:29019536

Abstract

OBJECTIVE

to study the correlation of trauma mechanism with frequency and severity of injuries in blunt trauma patients.

METHODS

retrospective analysis of trauma registry in a 15-month period was carried out. Trauma mechanism was classified into six types: occupants of four-wheeled vehicles involved in road traffic accidents (AUTO), pedestrians struck by road vehicles (PED), motorcyclists involved in road traffic accidents (MOTO), falls from height (FALL), physical assault with blunt instruments (ASSA) and falls on same level (FSL). Injuries with AIS>2 were considered severe. One-way ANOVA, Students t and Chi-square tests were used for statistical analysis, considering p<0.05 significant.

RESULTS

trauma mechanism was classified by group for 3639 cases, comprising 337 (9.3%) AUTO, 855 (23.5%) PED, 924 (25.4%) MOTO, 455 (12.5%) FALL, 424 (11.7%) ASSA and 644 (17.7%) FSL. There was significant difference among groups when comparing the Revised Trauma Score (RTS), the Injury Severity Score (ISS) and the Abbreviated Injury Scale (AIS) of the head, thorax, abdomen and extremities (p<0.001). Severe injuries in the head and in the extremities were more frequent in PED patients (p<0.001). Severe injuries to the chest were more frequent in AUTO (p<0.001). Abdominal injuries were less frequent in FSL (p=0.004). Complex fractures of the pelvis and spine were more frequent in FALL (p<0.001). Lethality was greater in PED, followed by FALL and AUTO (p<0.001).

CONCLUSION

trauma mechanism analysis predicted frequency and severity of injuries in blunt trauma patients.

摘要

目的

研究钝性创伤患者的创伤机制与损伤频率及严重程度之间的相关性。

方法

对15个月期间的创伤登记资料进行回顾性分析。创伤机制分为六种类型：四轮机动车道路交通事故中的驾乘人员（AUTO）、被道路车辆撞击的行人（PED）、摩托车道路交通事故中的驾乘人员（MOTO）、高处坠落（FALL）、钝器人身攻击（ASSA）以及同一平面跌倒（FSL）。AIS>2的损伤被视为严重损伤。采用单因素方差分析、学生t检验和卡方检验进行统计学分析，以p<0.05为有统计学意义。

结果

对3639例病例按组进行创伤机制分类，其中包括337例（9.3%）AUTO、855例（23.5%）PED、924例（25.4%）MOTO、455例（12.5%）FALL、424例（11.7%）ASSA和644例（17.7%）FSL。比较头部、胸部、腹部和四肢的修订创伤评分（RTS）、损伤严重程度评分（ISS）和简明损伤定级标准（AIS）时，各组间存在显著差异（p<0.001）。PED患者头部和四肢的严重损伤更为常见（p<0.001）。AUTO患者胸部严重损伤更为常见（p<0.001）。FSL患者腹部损伤较少见（p=0.004）。FALL患者骨盆和脊柱的复杂骨折更为常见（p<0.001）。PED患者的致死率更高，其次是FALL和AUTO（p<0.001）。