Division of Trauma/Acute Care Surgery/Surgical Critical Care, Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA, 90509, United States.
Division of Trauma/Acute Care Surgery/Surgical Critical Care, Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA, 90509, United States; Los Angeles BioMedical Research Institute, 1124 W. Carson St, Torrance, CA, 90502, United States.
Am J Surg. 2019 Dec;218(6):1185-1188. doi: 10.1016/j.amjsurg.2019.08.022. Epub 2019 Sep 10.
The early identification of hemorrhagic shock may be challenging. The objective of this study was to examine the utility of a narrowed pulse pressure in identifying the need for emergent interventions following penetrating trauma.
In this 2.5-year retrospective study of adult patients with a penetrating mechanism, patients with a narrowed pulse pressure (<30 mmHg) were compared to those without. Main outcomes measures were the need for a massive transfusion or emergent operation.
There were 957 patients, of which the majority were male (86%) and 55% presented with gunshot wounds. On multivariate analysis, a narrowed pulse pressure was associated with the need for massive transfusion (OR 3.74, 95% C.I. 1.8-7.7, p = 0.0003) and emergent surgery (OR 1.68, 95% C.I. 1.14-2.48, p = 0.009).
A narrowed pulse pressure is associated with the presence of hemorrhagic shock and need for emergent interventions among patients with penetrating torso trauma.
早期识别出血性休克可能具有挑战性。本研究的目的是检验缩窄的脉压在识别穿透性创伤后紧急干预需求方面的作用。
在这项为期 2.5 年的成人穿透性机制患者的回顾性研究中，比较了脉压缩窄（<30mmHg）的患者与无脉压缩窄的患者。主要结局指标是需要大量输血或紧急手术。
共纳入 957 例患者，其中大多数为男性（86%），55%为枪伤。多因素分析显示，脉压缩窄与大量输血（OR 3.74，95%CI 1.8-7.7，p=0.0003）和紧急手术（OR 1.68，95%CI 1.14-2.48，p=0.009）相关。
在穿透性胸外伤患者中，脉压缩窄与出血性休克的存在和紧急干预的需要相关。
