Maeshima Katsuya, Yamamoto Ryo, Sasaki Junichi
Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
Eur J Trauma Emerg Surg. 2022 Dec;48(6):4837-4845. doi: 10.1007/s00068-022-02008-8. Epub 2022 Jun 8.
This research aimed to establish a scoring system for selecting candidates for urgent angioembolization (AE).
Patients with blunt trauma were retrospectively identified in a nationwide trauma registry. Patients aged ≥ 15 years with a systolic blood pressure of ≥90 mmHg were included. These individuals were then categorized into development and validation cohorts based on the date of admission. Next, an eight-point scaled system was developed using odds ratios obtained from the multivariate analysis of patients' clinical factors on their arrival at the hospital, with the implementation of urgent AE as a dependent variable.
The development cohort and validation cohort included 158,192 and 116,941 patients, respectively, and 3296 (2.1%) patients in the development cohort and 2,550 (2.2%) patients in the validation cohort underwent urgent AE. The frequency of transfusion within 24 h after arrival and the Injury Severity Score were similar between the two cohorts (16,867 [10.7%] vs. 11,222 [9.6%] and 10 [9-18] vs. 10 [9-17], respectively). The number of patients who were discharged and hospital-free days were comparable between the two cohorts (139,436 [94.4%] vs. 106,107 [95.6%] and 72 [53-84] vs. 73 [57-84] days, respectively). The probabilities and the observed rates of urgent AE increased proportionally from 2% at a score of ≤ 3 to almost 15% at a score of ≥ 7. In terms of predictive factors, no significant interaction was noted.
The Trauma-Angio scoring system can be used as a trigger to suggest the possibility of urgent AE.
20090087, 31st July 2009.
本研究旨在建立一种用于筛选紧急血管栓塞术（AE）候选者的评分系统。
在全国创伤登记处对钝性创伤患者进行回顾性识别。纳入年龄≥15岁且收缩压≥90mmHg的患者。然后根据入院日期将这些个体分为开发队列和验证队列。接下来，使用从患者入院时临床因素的多变量分析中获得的比值比开发了一个八分制系统，将实施紧急AE作为因变量。
开发队列和验证队列分别包括158192例和116941例患者，开发队列中的3296例（2.1%）患者和验证队列中的2550例（2.2%）患者接受了紧急AE。两个队列到达后24小时内的输血频率和损伤严重程度评分相似（分别为16867例[10.7%]对11222例[9.6%]以及10[9 - 18]对10[9 - 17]）。两个队列中出院患者数量和无住院天数相当（分别为139436例[94.4%]对106107例[95.6%]以及72[53 - 84]天对73[57 - 84]天）。紧急AE的概率和观察到的发生率从≤3分的2%成比例增加到≥7分的近15%。在预测因素方面，未发现显著的相互作用。
创伤 - 血管评分系统可作为提示紧急AE可能性的触发因素。
20090087，2009年7月31日。
