Teixeira Lopes Maria Carolina Barbosa, de Aguiar Wagner, Yamaguchi Whitaker Iveth
Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil (Ms Lopes and Dr Whitaker); and Departamento de Emergência, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil (Mr de Aguiar).
J Trauma Nurs. 2019 Jan/Feb;26(1):10-16. doi: 10.1097/JTN.0000000000000411.
In-hospital complications in trauma patients are frequent and associated with increased morbidity and mortality. The aim of this study was to analyze the association between posttraumatic complications and the injured body region, injury and trauma severity, length of stay, and mortality in hospitalized trauma patients. This observational and retrospective study included 147 trauma patients with posttraumatic complications hospitalized in a university hospital located in São Paulo, Brazil. The injury and trauma severity was measured using the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS), respectively. The association between variables was verified applying χ test, Fisher exact text, likelihood ratio, and Mann-Whitney U test, considering significance level of 5%. The most frequent in-hospital complications were infectious, cardiovascular, metabolic, and renal. Patients with head injury AIS score of 3 or more had higher percentage of neurological complications and those with lower extremity injury AIS score of less than 3 had higher percentage of metabolic and renal complications. There was no association between thoracic injury and cardiovascular complications, nor between types of complications and trauma severity (ISS). Patients without cardiovascular complication and those with infections had longer hospital length of stay, and mortality was higher in those with cardiovascular complications. Complication's studies in trauma patients may contribute to identify events related with poor outcome and to implement specific measures for improving quality of trauma care and patient security.
创伤患者的院内并发症很常见,且与发病率和死亡率增加相关。本研究的目的是分析创伤后并发症与受伤身体部位、损伤和创伤严重程度、住院时间以及住院创伤患者死亡率之间的关联。这项观察性回顾性研究纳入了巴西圣保罗一家大学医院收治的147例有创伤后并发症的创伤患者。损伤和创伤严重程度分别使用简明损伤分级(AIS)和损伤严重度评分(ISS)进行测量。应用χ检验、Fisher确切概率法、似然比和Mann-Whitney U检验来验证变量之间的关联,显著性水平为5%。最常见的院内并发症为感染性、心血管性、代谢性和肾性并发症。简明损伤分级(AIS)评分为3分或更高的头部损伤患者神经并发症的发生率较高,而简明损伤分级(AIS)评分低于3分的下肢损伤患者代谢性和肾性并发症的发生率较高。胸部损伤与心血管并发症之间以及并发症类型与创伤严重程度(ISS)之间均无关联。无心血管并发症的患者和有感染的患者住院时间更长,有心血管并发症的患者死亡率更高。对创伤患者并发症的研究可能有助于识别与不良预后相关的事件,并实施提高创伤护理质量和患者安全的具体措施。