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入住重症监护病房的创伤患者的死亡风险因素。

Risk factors for death of trauma patients admitted to an Intensive Care Unit.

作者信息

Lentsck Maicon Henrique, Oliveira Rosana Rosseto de, Corona Ligiana Pires, Mathias Thais Aidar de Freitas

机构信息

Universidade Estadual de Maringá, Departamento de Enfermagem, Maringá, PR, Brazil.

Universidade Estadual do Centro-Oeste, Departamento de Enfermagem, Guarapuava, PR, Brazil.

出版信息

Rev Lat Am Enfermagem. 2020 Feb 14;28:e3236. doi: 10.1590/1518-8345.3482.3236. eCollection 2020.

Abstract

OBJECTIVE

To analyze the risk factors for death of trauma patients admitted to the intensive care unit (ICU).

METHOD

Retrospective cohort study with data from medical records of adults hospitalized for trauma in a general intensive care unit. We included patients 18 years of age and older and admitted for injuries. The variables were grouped into levels in a hierarchical manner. The distal level included sociodemographic variables, hospitalization, cause of trauma and comorbidities; the intermediate, the characteristics of trauma and prehospital care; the proximal, the variables of prognostic indices, intensive admission, procedures and complications. Multiple logistic regression analysis was performed.

RESULTS

The risk factors associated with death at the distal level were age 60 years or older and comorbidities; at intermediate level, severity of trauma and proximal level, severe circulatory complications, vasoactive drug use, mechanical ventilation, renal dysfunction, failure to perform blood culture on admission and Acute Physiology and Chronic Health Evaluation II.

CONCLUSION

The identified factors are useful to compose a clinical profile and to plan intensive care to avoid complications and deaths of traumatized patients.

摘要

目的

分析入住重症监护病房(ICU)的创伤患者的死亡危险因素。

方法

采用回顾性队列研究,数据来源于一家综合重症监护病房收治的成年创伤住院患者的病历。我们纳入了18岁及以上因伤入院的患者。变量以分层方式分组。最远端层次包括社会人口统计学变量、住院情况、创伤原因和合并症;中间层次为创伤特征和院前护理;最近端层次为预后指标、重症监护入院、操作和并发症等变量。进行了多因素逻辑回归分析。

结果

在最远端层次与死亡相关的危险因素是60岁及以上年龄和合并症;在中间层次是创伤严重程度,在最近端层次是严重循环并发症、使用血管活性药物、机械通气、肾功能不全、入院时未进行血培养以及急性生理与慢性健康状况评分系统II(APACHE II)。

结论

所确定的因素有助于构建临床概况并规划重症监护,以避免创伤患者出现并发症和死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dbc/7021481/a818d078b8b1/0104-1169-rlae-28-e3236-gf01.jpg

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