吸烟对青少年创伤患者的影响：一项倾向评分匹配分析。
The effects of smoking on adolescent trauma patients: a propensity-score-matched analysis.
作者信息
Kojayan Greg Garo, Grigorian Areg, Schubl Sebastian D, Kuza Catherine M, Dolich Matthew, Bashir Rame, Nahmias Jeffry
机构信息
Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
Department of Anesthesiology, University of Southern California, Los Angeles, CA, USA.
出版信息
Pediatr Surg Int. 2020 Jun;36(6):743-749. doi: 10.1007/s00383-020-04654-8. Epub 2020 Mar 31.
PURPOSE
Cigarettes have been demonstrated to be toxic to the pulmonary connective tissue by impairing the lung's ability to clear debris, resulting in infection and acute respiratory distress syndrome (ARDS). Approximately 8% of adolescents are smokers. We hypothesized that adolescent trauma patients who smoke have a higher rate of ARDS and pneumonia when compared to non-smokers.
METHODS
The Trauma Quality Improvement Program (2014-2016) was queried for adolescent trauma patients aged 13-17 years. Adolescent smokers were 1:2 propensity-score-matched to non-smokers based on age, comorbidities, and injury type. Data were analyzed using chi square for categorical data and Mann-Whitney U test for continuous data.
RESULTS
From 32,610 adolescent patients, 997 (3.1%) were smokers. After matching, 459 smokers were compared to 918 non-smokers. There were no differences in matched characteristics. Compared to non-smokers, smokers had an increased rate of pneumonia (3.1% vs. 1.1%, p = 0.01) but not ARDS (0.2% vs. 0%, p = 0.16). Compared to the non-smoking group, the smokers had a longer median total hospital length-of-stay (3 vs. 2 days, p = 0.01) and no difference in overall mortality (1.5% vs. 2.4%, p = 0.29).
CONCLUSION
Smoking is associated with an increased rate of pneumonia in adolescent trauma patients. Future research should target smoking cessation and/or interventions to mitigate the deleterious effects of smoking in this population.
目的
香烟已被证明对肺结缔组织有毒性，它会损害肺部清除碎屑的能力，从而导致感染和急性呼吸窘迫综合征（ARDS）。约8%的青少年吸烟。我们假设，与不吸烟的青少年创伤患者相比，吸烟的青少年创伤患者发生ARDS和肺炎的几率更高。
方法
查询创伤质量改进项目（2014 - 2016年）中年龄在13 - 17岁的青少年创伤患者。根据年龄、合并症和损伤类型，将青少年吸烟者与不吸烟者按1:2的倾向评分进行匹配。分类数据采用卡方检验分析，连续数据采用曼 - 惠特尼U检验分析。
结果
在32610例青少年患者中，997例（3.1%）为吸烟者。匹配后，将459例吸烟者与918例不吸烟者进行比较。匹配特征无差异。与不吸烟者相比，吸烟者的肺炎发生率更高（3.1%对1.1%，p = 0.01），但ARDS发生率无差异（0.2%对0%，p = 0.16）。与不吸烟组相比，吸烟者的中位总住院时间更长（3天对2天，p = 0.01），总体死亡率无差异（1.5%对2.4%，p = 0.29）。
结论
吸烟与青少年创伤患者肺炎发生率增加有关。未来的研究应针对戒烟和/或采取干预措施，以减轻吸烟对该人群的有害影响。
Zotero 插件