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创伤性骨盆骨折患者的预后决定因素:伊朗南部一级创伤中心的队列研究

Outcome Determinants of Patients with Traumatic Pelvic Fractures: A Cohort Study in a Level I Trauma Center in Southern Iran.

作者信息

Paydar S, Chaabi M, Akhavan M, Ghahramani Z, Dehghankhalili M

机构信息

Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Malays Orthop J. 2017 Nov;11(3):23-30. doi: 10.5704/MOJ.1711.012.

Abstract

Pelvic fracture is a result of devastating injuries and is usually encountered in conjunction with other life-threatening injuries. The aim of the current study was to determine the outcome determinants of patients with pelvic fractures referred to a large trauma center in southern Iran. This retrospective cross-sectional study was conducted in a level I trauma center over a period of three years from 2012 to 2015. We included all patients with pelvic fractures whose medical records had sufficient data. Data were compared between good condition and poor conditions. A total of 327 patients with mean age of 40.1 ± 19.7 years were included. Poor condition was defined as being associated with higher heart rate (p=0.002), lower systolic blood pressure (p<0.001), lower diastolic blood pressure (p=0.002) lower Glasgow Coma Scale (GCS) on admission (p<0.001) and higher Injury Severity Score (ISS) (p<0.001). Those with poor conditions had significantly higher admission to ICU (p<0.001), higher rate of surgical interventions (p<0.001) and higher mortality (p<0.001). The hospital length of stay (p<0.001) and ICU length of stay (p=0.025) were also longer in those with poor condition. Lower hemoglobin, lower pH, higher heart rate, lower systolic blood pressure, lower GCS on admission and higher ISS were important outcome determinants of traumatic pelvic fractures.

摘要

骨盆骨折是严重损伤的结果,通常与其他危及生命的损伤同时出现。本研究的目的是确定转诊至伊朗南部一家大型创伤中心的骨盆骨折患者的预后决定因素。这项回顾性横断面研究在一家一级创伤中心进行,为期三年,从2012年至2015年。我们纳入了所有病历资料充足的骨盆骨折患者。对病情良好和病情较差的患者的数据进行了比较。共纳入327例患者,平均年龄为40.1±19.7岁。病情较差被定义为与较高的心率相关(p=0.002)、较低的收缩压(p<0.001)、较低的舒张压(p=0.002)、入院时较低的格拉斯哥昏迷量表(GCS)评分(p<0.001)以及较高的损伤严重程度评分(ISS)(p<0.001)。病情较差的患者入住重症监护病房(ICU)的比例显著更高(p<0.001)、手术干预率更高(p<0.001)且死亡率更高(p<0.001)。病情较差患者的住院时间(p<0.001)和ICU住院时间(p=0.025)也更长。较低的血红蛋白、较低的pH值、较高的心率、较低的收缩压、入院时较低的GCS评分以及较高的ISS是创伤性骨盆骨折重要的预后决定因素。

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Pelvic fracture: the last 50 years.骨盆骨折:过去的50年
J Trauma. 2010 Sep;69(3):483-8. doi: 10.1097/TA.0b013e3181ef9ce1.

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