Ishida Kenichiro, Katayama Yusuke, Kitamura Tetsuhisa, Hirose Tomoya, Ojima Masahiro, Nakao Shunichiro, Tachino Jotaro, Umemura Yutaka, Kiguchi Takeyuki, Matsuyama Tasuku, Noda Tomohiro, Kiyohara Kosuke, Oda Jun, Ohnishi Mitsuo
Department of Acute Medicine and Critical Care Medical Center, Osaka National Hospital, National Hospital Organization, Osaka 540-0006, Japan.
Department of Traumatology and Acute Critical Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan.
J Clin Med. 2022 Aug 3;11(15):4534. doi: 10.3390/jcm11154534.
The lack of established diagnostic criteria makes diagnosing blunt cardiac injury difficult. We investigated the factors associated with blunt cardiac injury using the Japan Trauma Data Bank (JTDB) in a multicenter observational study of blunt trauma patients conducted between 2004 and 2018. The primary outcome was the incidence of blunt cardiac/pericardial injury. Multivariable logistic regression analysis was used to identify factors independently associated with blunt cardiac injuries. Of the 228,513 patients, 1002 (0.4%) had blunt cardiac injury. Hypotension on hospital arrival (adjusted odds ratio (AOR) 4.536, 95% confidence interval (CI) 3.802-5.412), thoracic aortic injury (AOR 2.722, 95% CI 1.947-3.806), pulmonary contusion (AOR 2.532, 95% CI 2.204-2.909), rib fracture (AOR 1.362, 95% CI 1.147-1.618), sternal fracture (AOR 3.319, 95% CI 2.696-4.085). and hemothorax/pneumothorax (AOR 1.689, 95% CI 1.423-2.006)) was positively associated with blunt cardiac injury. Regarding the types of patients, car drivers had a higher rate of blunt cardiac injury compared to other types of patients. Driving a car, hypotension on hospital arrival, thoracic aortic injury, pulmonary contusion, rib fracture, sternal fracture, and hemothorax/pneumothorax were positively associated with blunt cardiac injury.
由于缺乏既定的诊断标准，钝性心脏损伤的诊断较为困难。我们在一项对2004年至2018年间钝性创伤患者进行的多中心观察性研究中，利用日本创伤数据库（JTDB）调查了与钝性心脏损伤相关的因素。主要结局是钝性心脏/心包损伤的发生率。采用多变量逻辑回归分析来确定与钝性心脏损伤独立相关的因素。在228,513例患者中，1002例（0.4%）发生钝性心脏损伤。入院时低血压（调整比值比（AOR）4.536，95%置信区间（CI）3.802 - 5.412）、胸主动脉损伤（AOR 2.722，95% CI 1.947 - 3.806）、肺挫伤（AOR 2.532，95% CI 2.204 - 2.909）、肋骨骨折（AOR 1.362，95% CI 1.147 - 1.618）、胸骨骨折（AOR 3.319，95% CI 2.696 - 4.085）以及血胸/气胸（AOR 1.689，95% CI 1.423 - 2.006）与钝性心脏损伤呈正相关。在患者类型方面，与其他类型的患者相比，汽车驾驶员钝性心脏损伤的发生率更高。驾驶汽车、入院时低血压、胸主动脉损伤、肺挫伤、肋骨骨折、胸骨骨折以及血胸/气胸与钝性心脏损伤呈正相关。
