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中国成人溺水患者的神经学转归。

Neurological outcomes in adult drowning patients in China.

机构信息

From the Department of Emergency Medicine, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China.

From the Department of Emergency Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China.

出版信息

Ann Saudi Med. 2022 Mar-Apr;42(2):127-138. doi: 10.5144/0256-4947.2022.127. Epub 2022 Apr 7.

Abstract

BACKGROUND

Drowning is the third leading cause of unintentional death worldwide. The epidemiological characteristics of adult drownings are rarely reported.

OBJECTIVE

Investigate factors associated with neurological prognosis in adult drowning inpatients.

DESIGN

Multicenter medical record review.

SETTING

Tertiary health care institutions.

PATIENTS AND METHODS

We collected demographic and clinical data on patients who drowned but survived between September 2006 and January 2020. Neurological prognosis was compared in patients with and without cardiac arrest.

MAIN OUTCOME MEASURES

Neurological outcomes.

SAMPLE SIZE AND CHARACTERISTICS

142 patients with mean age of 50.6 (19.8) years, male/female ratio of 1.54:1.

RESULT

Forty-five patients (31.7%) received CPR, 90 patients (63.4%) experienced unconsciousness, and 59 patients (41.5%) received endotracheal intubation and mechanical ventilation. Multivariate logistic regression analysis showed that the initial blood lactic acid level (OR: 7.67, 95%CI: 1.23-47.82, =.029) was associated with a poor neurological prognosis in patients without cardiac arrest. The incidence of ICU admission (OR: 16.604, 95%CI: 1.15-239.49, =.039) was associated with a poor neurologic prognosis in patients with cardiac arrest.

CONCLUSIONS

For the drowning patients with cardiac arrest, ICU admission was associated with neurological function prognosis in these patients. Among the patients without cardiac arrest, the initial lactate value was associated with neurological function prognosis of these patients.

LIMITATIONS

Retrospective.

CONFLICT OF INTEREST

None.

摘要

背景

溺水是全世界导致非故意伤害死亡的第三大原因。成人溺水的流行病学特征很少有报道。

目的

调查与成人溺水住院患者神经预后相关的因素。

设计

多中心病历回顾。

设置

三级医疗机构。

患者和方法

我们收集了 2006 年 9 月至 2020 年 1 月期间溺水但幸存的患者的人口统计学和临床数据。比较了有和无心脏骤停患者的神经预后。

主要观察指标

神经预后。

样本量和特征

142 例患者,平均年龄 50.6(19.8)岁,男女比例为 1.54:1。

结果

45 例(31.7%)患者接受了心肺复苏术(CPR),90 例(63.4%)患者无意识,59 例(41.5%)患者接受了气管插管和机械通气。多变量逻辑回归分析显示,无心脏骤停患者的初始血乳酸水平(OR:7.67,95%CI:1.23-47.82,=.029)与不良神经预后相关。入住 ICU(OR:16.604,95%CI:1.15-239.49,=.039)与心脏骤停患者的不良神经预后相关。

结论

对于心脏骤停的溺水患者,入住 ICU 与这些患者的神经功能预后相关。在无心脏骤停的患者中,初始乳酸值与这些患者的神经功能预后相关。

局限性

回顾性。

利益冲突

无。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81f/8982001/a022239af8eb/0256-4947.2022.127-fig01.jpg

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