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严重创伤指数在重症监护患者中的应用:对死亡率的预测能力。

Severity indexes of blunt trauma victims in intensive therapy: prediction capacity for mortality.

机构信息

Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem na Saúde do Adulto, São Paulo, SP, Brasil.

Faculdade dos Carajás, Marabá, PA, Brasil.

出版信息

Rev Esc Enferm USP. 2021 May 31;55:e03747. doi: 10.1590/S1980-220X2020003203747. eCollection 2021.

Abstract

OBJECTIVE

To identify the predictive capacity for mortality of the indexes Revised Trauma Score, Rapid Emergency Medicine Score, modified Rapid Emergency Medicine Score, and Simplified Acute Physiology Score III in blunt trauma victims hospitalized in an intensive care unit and compare their performance.

METHOD

Retrospective cohort of patients with blunt trauma in an intensive care unit from medical records. Receiver Operating Characteristic and a 95% confidence interval of the area under the curve were analyzed to compare results.

RESULTS

Out of 165 analyzed patients, 66.7% have received surgical treatment. The mortality in the intensive care unit and in the hospital was 17.6% and 20.6%, respectively. For the mortality in the intensive care unit, the area under the curve varied from 0.672 to 0.738; however, better results have been observed in surgical patients (0.747 to 0.811). Similar results have been observed for in-hospital mortality. In all analyses, the areas under the curve of the indexes presented no significant difference.

CONCLUSION

The accuracy of the severity indexes was moderate, with an improved performance when applied to surgical patients. The four indexes presented a similar prediction for the analyzed outcomes.

摘要

目的

确定修订后的创伤评分、快速急诊医学评分、改良快速急诊医学评分和简化急性生理学评分 III 等指标对重症监护病房钝性创伤患者死亡率的预测能力,并比较其性能。

方法

回顾性分析重症监护病房钝性创伤患者的病历。分析受试者工作特征曲线和曲线下 95%置信区间,以比较结果。

结果

在分析的 165 名患者中,66.7%接受了手术治疗。重症监护病房和医院的死亡率分别为 17.6%和 20.6%。对于重症监护病房的死亡率,曲线下面积从 0.672 到 0.738 不等;然而,在手术患者中观察到了更好的结果(0.747 至 0.811)。在所有分析中,所分析的结局的指数曲线下面积无显著差异。

结论

严重程度指数的准确性为中等,应用于手术患者时性能有所提高。这四个指标对分析结果的预测能力相似。

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