State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical Center, Army Medical University Daping Hospital, Chongqing, China.
Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
BMJ Open. 2022 Jun 9;12(6):e058612. doi: 10.1136/bmjopen-2021-058612.
This study analyses the clinical features and direct medical cost (DMC) of splenic injury during 2000-2013 in China.
This was a cross-sectional study.
We used 'The No. 1 Military Medical Project' information system to conduct a retrospective study. Patients' information from 2000 to 2013 were identified. Demographic data, treatment, clinical data and DMC were collected. We performed a generalised linear method (GLM) using gamma distribution to assess the drivers of DMCs.
We included 8083 patients with splenic injury who met the study criteria. Over the 14-year study period, 2782 (34.4%) patients were treated with non-operative management (NOM), 5301 (65.6%) with OM. From 2000 to 2013, the rate of NOM increased from 34.7% to 55.9%, while OM decreased from 65.3% to 44.1%. Mean per-patient DMC in both NOM and OM increased from 2000 to 2013. In GLM analysis, male, old age, length of stay, severe splenic injury grade, OM, intensive care unit, blood transfusion and tertiary hospitals were associated with higher DMC, while female and NOM was associated with lower DMC.
In China, management of splenic injury was the most important factor impacting the total DMC. Proper management and public policy could curtail the burden of splenic injury.
本研究分析了 2000-2013 年期间中国脾损伤的临床特征和直接医疗费用（DMC）。
这是一项横断面研究。
我们使用“第一军医大学项目”信息系统进行回顾性研究。确定了 2000 年至 2013 年期间的患者信息。收集了人口统计学数据、治疗、临床数据和 DMC。我们使用广义线性方法（GLM）使用伽马分布来评估 DMC 的驱动因素。
我们纳入了符合研究标准的 8083 例脾损伤患者。在 14 年的研究期间，2782 例（34.4%）患者接受了非手术治疗（NOM），5301 例（65.6%）接受了手术治疗（OM）。从 2000 年到 2013 年，NOM 的比例从 34.7%增加到 55.9%，而 OM 的比例从 65.3%下降到 44.1%。NOM 和 OM 中每位患者的平均 DMC 从 2000 年到 2013 年都有所增加。在 GLM 分析中，男性、年龄较大、住院时间较长、严重脾损伤程度、OM、重症监护病房、输血和三级医院与较高的 DMC 相关，而女性和 NOM 与较低的 DMC 相关。
在中国，脾损伤的治疗是影响总 DMC 的最重要因素。适当的治疗和公共政策可以减轻脾损伤的负担。
