Rezaei Bareza, Ramazani Einaz, Amiri Rahimpour, Sanaei Zahra
Department of Emergency, Faculty of Medicine, Taleghani Hospital Kermanshah University of Medical Sciences Kermanshah Iran.
Clinical Research Development Center of Taleghani Kermanshah University of Medical Sciences Kermanshah Iran.
Health Sci Rep. 2021 Mar 10;4(2):e239. doi: 10.1002/hsr2.239. eCollection 2021 Jun.
Evaluation of electrolyte status and homeostasis is one of the most important components of evaluation and treatment of critically ill patients, especially those with multiple trauma. Electrolyte imbalance can be associated with a bad prognosis and the need of specialized consultancy.
The aim of this study was to evaluate and determine the electrolyte status of patients with multiple trauma and evaluate the relationship of electrolyte disorders with patient outcome.
In this cross-sectional study, 370 patients who were referred to the emergency department of Besat Hospital in Hamadan, Iran with multiple trauma were studied. Demographic parameters clinical characteristics such as blood pressure, heart rate, respiratory rate, consciousness score and body temperature, paraclinical characteristics including radiographic status, ultrasound, and electrocardiography and serum levels of sodium, potassium, creatinine, hemoglobin, hematocrit, and BUN and urine analysis was performed. Data regarding the discharge from emergency department or referral to other units were also complete in a questionnaire for each patient. Statistical analyses were performed using SPSSv24.
Three hundred seventy patients with multiple trauma were studied where 73% of patients were men and 27% were women. One hundred ninety-six patients were discharged from the emergency department, and 174 patients were referred to other units of the hospital. The most common electrolyte abnormalities were hypotension (62.7%), hypernatremia (9.5%), hypokalemia (6.8%), and hypercreatinine (4.6%). The results of independent -test showed that heart rate and potassium level were significantly higher in patients referred to other units than in patients discharged from the emergency department and respiratory rate and hematocrit were significantly lower in patients referred to other units.
Hypotension, hypernatremia, hypokalemia, hypercreatinine, and abnormal urine analysis were more frequent in patients referred to other units than in patients discharged from the emergency department. These variables can be considered in predicting patient status for referral to other units and delayed hospital discharge.
评估电解质状态和内稳态是危重症患者评估与治疗的最重要组成部分之一，尤其是对于多发伤患者。电解质失衡可能与不良预后及需要专业会诊相关。
本研究的目的是评估和确定多发伤患者的电解质状态，并评估电解质紊乱与患者预后的关系。
在这项横断面研究中，对370例转诊至伊朗哈马丹贝萨特医院急诊科的多发伤患者进行了研究。记录人口统计学参数、临床特征（如血压、心率、呼吸频率、意识评分和体温）、辅助检查特征（包括影像学检查结果、超声和心电图）以及血清钠、钾、肌酐、血红蛋白、血细胞比容、尿素氮水平，并进行尿液分析。关于患者从急诊科出院或转诊至其他科室的数据也通过针对每位患者的问卷得以完善。使用SPSSv24进行统计分析。
共研究了370例多发伤患者，其中73%为男性，27%为女性。196例患者从急诊科出院，174例患者转诊至医院其他科室。最常见的电解质异常为低血压（62.7%）、高钠血症（9.5%）、低钾血症（6.8%）和血肌酐升高（4.6%）。独立样本t检验结果显示，转诊至其他科室的患者心率和钾水平显著高于从急诊科出院的患者，而转诊至其他科室的患者呼吸频率和血细胞比容显著低于从急诊科出院的患者。
转诊至其他科室的患者比从急诊科出院的患者更常出现低血压、高钠血症、低钾血症、血肌酐升高及尿液分析异常。在预测患者转诊至其他科室及延迟出院的情况时可考虑这些变量。
