胸部或腹部损伤患者创伤性膈肌破裂的相关因素：一项来自日本的全国性研究

Factors Associated with Traumatic Diaphragmatic Rupture among Patients with Chest or Abdominal Injury: A Nationwide Study from Japan.

作者信息

Katayama Yusuke, Tanaka Kenta, Ishida Kenichiro, Hirose Tomoya, Tachino Jotaro, Nakao Shunichiro, Umemura Yutaka, Kiyohara Kosuke, Ojima Masahiro, Kiguchi Takeyuki, Kitamura Tetsuhisa, Oda Jun

机构信息

Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.

Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.

出版信息

J Clin Med. 2022 Jul 30;11(15):4462. doi: 10.3390/jcm11154462.

DOI:10.3390/jcm11154462

PMID:35956077

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9369230/

Abstract

BACKGROUND

Blunt traumatic diaphragmatic rupture (TDR) is a rare condition that is seen in patients with blunt thoracoabdominal trauma. However, factors that are associated with blunt TDR have not been fully revealed. The purpose of this study was to evaluate the factors that are associated with blunt TDR in trauma patients with a chest or abdominal injury using nationwide trauma registry data in Japan.

METHOD

This study was a retrospective observational study with a 15-year study period from 2004 to 2018. We included trauma patients with a chest or abdominal Abbreviated Injury Score of two or more. We evaluated the relationship between confounding factors such as mechanism of injury and blunt TDR with multivariable logistic regression analysis.

RESULTS

This study included 65,110 patients, of whom 496 patients (0.8%) suffered blunt TDR. Factors that were associated with blunt TDR were disturbance of consciousness (adjusted OR [AOR]: 1.639, 95% CI: 1.326-2.026), FAST positive (AOR: 2.120, 95% CI: 1.751-2.567), front seat passenger (AOR: 1.748, 95% CI: 1.129-2.706), and compression injury by heavy object (AOR: 1.677, 95% CI: 1.017-2.765).

CONCLUSION

This study revealed several factors that are associated with blunt TDR. The results of this study may be useful for clinicians when estimating blunt TDR.

摘要

背景

钝性创伤性膈肌破裂（TDR）是一种在钝性胸腹联合伤患者中较为罕见的病症。然而，与钝性TDR相关的因素尚未完全明确。本研究旨在利用日本全国创伤登记数据，评估胸部或腹部受伤的创伤患者中与钝性TDR相关的因素。

方法

本研究是一项回顾性观察研究，研究期为2004年至2018年，共15年。我们纳入了简略损伤评分为2分或更高的胸部或腹部创伤患者。我们通过多变量逻辑回归分析评估损伤机制等混杂因素与钝性TDR之间的关系。

结果

本研究共纳入65110例患者，其中496例（0.8%）发生钝性TDR。与钝性TDR相关的因素包括意识障碍（校正比值比[AOR]：1.639，95%置信区间：1.326 - 2.026）、FAST检查阳性（AOR：2.120，95%置信区间：1.751 - 2.567）、前排乘客（AOR：1.748，95%置信区间：1.129 - 2.706）以及重物挤压伤（AOR：1.677，95%置信区间：1.017 - 2.765）。