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是出于好奇还是漏诊?胸腰椎脊柱损伤合并胰腺创伤

Curiosity or Underdiagnosed? Injuries to Thoracolumbar Spine with Concomitant Trauma to Pancreas.

作者信息

Hax Jakob, Halvachizadeh Sascha, Jensen Kai Oliver, Berk Till, Teuber Henrik, Di Primio Teresa, Lefering Rolf, Pape Hans-Christoph, Sprengel Kai

机构信息

Department of Trauma, University Hospital Zurich, 8091 Zurich, Switzerland.

Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, 51109 Cologne, Germany.

出版信息

J Clin Med. 2021 Feb 11;10(4):700. doi: 10.3390/jcm10040700.

Abstract

The pancreas is at risk of damage as a consequence of thoracolumbar spine injury. However, there are no studies providing prevalence data to support this assumption. Data from European hospitals documented in the TraumaRegister DGU (TR-DGU) between 2008-2017 were analyzed to estimate the prevalence of this correlation and to determine the impact on clinical outcome. A total of 44,279 patients with significant thoracolumbar trauma, defined on Abbreviated Injury Scale (AIS) as ≥2, were included. Patients transferred to another hospital within 48 h were excluded to prevent double counting. A total of 135,567 patients without thoracolumbar injuries (AIS ≤ 1) were used as control group. Four-hundred patients with thoracolumbar trauma had a pancreatic injury. Pancreatic injuries were more common after thoracolumbar trauma (0.90% versus (vs.) 0.51%, odds ratio (OR) 1.78; 95% confidence intervals (CI), 1.57-2.01). Patients with pancreatic injuries were more likely to be male (68%) and had a higher mean Injury Severity Score (ISS) than those without (35.7 ± 16.0 vs. 23.8 ± 12.4). Mean length of stay (LOS) in intensive care unit (ICU) and hospital was longer with pancreatic injury. In-hospital mortality was 17.5% with and 9.7% without pancreatic injury, respectively. Although uncommon, concurrent pancreatic injury in the setting of thoracolumbar trauma can portend a much more serious injury.

摘要

胸腰椎损伤可能会导致胰腺受损。然而,尚无研究提供患病率数据来支持这一假设。对2008年至2017年间创伤注册数据库DGU(TR-DGU)中记录的欧洲医院数据进行分析,以估计这种相关性的患病率,并确定其对临床结局的影响。总共纳入了44279例胸腰椎严重创伤患者,根据简明损伤定级标准(AIS)定义为≥2级。排除48小时内转至其他医院的患者以避免重复计数。总共135567例无胸腰椎损伤(AIS≤1)的患者作为对照组。400例胸腰椎创伤患者发生了胰腺损伤。胸腰椎创伤后胰腺损伤更为常见(0.90%对0.51%,比值比(OR)1.78;95%置信区间(CI),1.57 - 2.01)。胰腺损伤患者更可能为男性(68%),且其平均损伤严重程度评分(ISS)高于未发生胰腺损伤的患者(35.7±16.0对23.8±12.4)。胰腺损伤患者在重症监护病房(ICU)和医院的平均住院时间更长。住院死亡率在有胰腺损伤和无胰腺损伤的患者中分别为17.5%和9.7%。虽然不常见,但胸腰椎创伤合并胰腺损伤可能预示着更严重的损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08b/7916827/8d0a702686e5/jcm-10-00700-g001.jpg

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