行人受伤患者医院死亡率的危险因素分析；伊朗南部一级创伤中心的数据集分析

Analysis of Risk Factors with Hospital Mortality in Pedestrian Injured Patients; A Dataset Analysis of a Level-I Trauma Center in Southern Iran.

作者信息

Yadollahi Mahnaz, Rahmanian Narges, Jamali Kazem

机构信息

Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Bull Emerg Trauma. 2018 Oct;6(4):349-354. doi: 10.29252/beat-060413.

DOI:10.29252/beat-060413

PMID:30402525

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6215079/

Abstract

OBJECTIVE

To determine the indicators predicting the hospital mortality in pedestrian injured patients admitted to a level I trauma center in Southern Iran.

METHODS

This case control study was conducted in a Level-I trauma hospital in Shiraz. We selected all survived pedestrians who were admitted in the hospital with duration of admission more than 24 hours in one year from March 2016 to February 2017 as control group and compared with all non-survived pedestrian patients who expired in the hospital according to clinical from March 2012 to February 2017. Multiple logistic regression was performed to identify factors of hospital effect on pedestrian mortality and results expressed by Odds Ratios and their confidence intervals (CI) of 95%.

RESULTS

A total of 424 survived pedestrian injured patients were compare to 117 non-survived one. Their mean of survived and non-survived patients were 43.79 ± 19.37 and 56.76 ± 18.55 years respectively of which 361 (66.7%) and 180 (33.3%) were men and women, respectively. We found that the gender does not have any relation with hospital mortality (p=0.275). Followed by, age is in relevance with mortality. Glasgow Coma Scale(GCS), Injury Severity Score (ISS), blood urea nitrogen (BUN), platelet (PLT), potassium (K) and hemoglobin (Hb) are significant factor which are associated with mortality. According to logistic analysis GCS ≤8 (<0.001), low hemoglobin level <9 (=0.030), BUN >24 (<0.001), thrombocytopenia <150,000 (<0.001), and hypokalemia <3.5 (=0.01) were independently associated with hospital mortality. Among them, GCS≤8 was 72.237 times more likely to be associated with hospital mortality (OR =72.24, CI95% =23.19- 225.05).

CONCLUSION

The results suggest that GCS score, ISS, hemoglobin level, platelet count, BUN and potassium level might be independent factors associated with hospital mortality in pedestrian injured patients.

摘要

目的

确定预测伊朗南部一家一级创伤中心收治的行人受伤患者院内死亡率的指标。

方法

本病例对照研究在设拉子的一家一级创伤医院进行。我们选取了2016年3月至2017年2月期间在该医院住院时间超过24小时的所有存活行人作为对照组，并与2012年3月至2017年2月期间在医院死亡的所有非存活行人患者进行临床比较。采用多因素逻辑回归分析确定影响行人死亡率的医院相关因素，结果以比值比及其95%置信区间（CI）表示。

结果

共424例存活的行人受伤患者与117例非存活患者进行了比较。存活患者和非存活患者的平均年龄分别为43.79±19.37岁和56.76±18.55岁，其中男性分别为361例（66.7%）和180例（33.3%），女性分别为63例（14.9%）和37例（8.7%）。我们发现性别与院内死亡率无任何关系（p=0.275）。其次，年龄与死亡率相关。格拉斯哥昏迷量表（GCS）、损伤严重程度评分（ISS）、血尿素氮（BUN）、血小板（PLT）、钾（K）和血红蛋白（Hb）是与死亡率相关的重要因素。根据逻辑分析，GCS≤8（<0.001）、低血红蛋白水平<9（=0.030）、BUN>24（<0.001）、血小板减少<150,000（<0.001）和低钾血症<3.5（=0.01）与院内死亡率独立相关。其中，GCS≤8与院内死亡率相关的可能性高72.237倍（OR=72.24，CI95%=23.19-225.05）。