Barea-Mendoza Jesús Abelardo, Chico-Fernández Mario, Quintana-Díaz Manuel, Pérez-Bárcena Jon, Serviá-Goixart Luís, Molina-Díaz Ismael, Bringas-Bollada María, Ruiz-Aguilar Antonio Luis, Ballesteros-Sanz María Ángeles, Llompart-Pou Juan Antonio
UCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.
Servicio de Medicina Intensiva, Hospital Universitario La Paz, 28046 Madrid, Spain.
J Clin Med. 2022 Jan 5;11(1):266. doi: 10.3390/jcm11010266.
Our objective was to determine outcomes of severe chest trauma admitted to the ICU and the risk factors associated with mortality. An observational, prospective, and multicenter registry of trauma patients admitted to the participating ICUs (March 2015-December 2019) was utilized to collect the patient data that were analyzed. Severe chest trauma was defined as an Abbreviated Injury Scale (AIS) value of ≥3 in the thoracic area. Logistic regression analysis was used to evaluate the contribution of severe chest trauma to crude and adjusted ORs for mortality and to analyze the risk factors associated with mortality. Overall, 3821 patients (39%) presented severe chest trauma. The sample's characteristics were as follows: a mean age of 49.88 (19.21) years, male (77.6%), blunt trauma (93.9%), a mean ISS of 19.9 (11.6). Crude and adjusted (for age and ISS) ORs for mortality in severe chest trauma were 0.78 (0.68-0.89) and 0.43 (0.37-0.50) ( < 0.001), respectively. In-hospital mortality in the severe chest trauma patients without significant traumatic brain injury (TBI) was 5.63% and was 25.71% with associated significant TBI ( < 0.001). Age, the severity of injury (NISS and AIS-head), hemodynamic instability, prehospital intubation, acute kidney injury, and multiorgan failure were risk factors associated with mortality. The contribution of severe chest injury to the mortality of trauma patients admitted to the ICU was very low. Risk factors associated with mortality were identified.
我们的目标是确定入住重症监护病房（ICU）的严重胸部创伤患者的治疗结果以及与死亡率相关的危险因素。我们利用一项针对入住参与研究的ICU的创伤患者的观察性、前瞻性多中心登记研究（2015年3月至2019年12月）来收集并分析患者数据。严重胸部创伤定义为胸部区域简明损伤定级（AIS）值≥3。采用逻辑回归分析来评估严重胸部创伤对死亡率的粗比值比（OR）和调整后OR的影响，并分析与死亡率相关的危险因素。总体而言，3821例患者（39%）存在严重胸部创伤。样本特征如下：平均年龄49.88（19.21）岁，男性（77.6%），钝性创伤（93.9%），平均损伤严重度评分（ISS）为19.9（11.6）。严重胸部创伤患者死亡率的粗OR和调整后（针对年龄和ISS）OR分别为0.78（0.68 - 0.89）和0.43（0.37 - 0.50）（P < 0.001）。无严重创伤性脑损伤（TBI）的严重胸部创伤患者的院内死亡率为5.63%，伴有严重TBI的患者为25.71%（P < 0.001）。年龄、损伤严重程度（NISS和AIS - 头部）、血流动力学不稳定、院前插管、急性肾损伤和多器官功能衰竭是与死亡率相关的危险因素。严重胸部损伤对入住ICU的创伤患者死亡率的影响非常低。确定了与死亡率相关的危险因素。
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