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骨盆骨折部位对钝性创伤患者纤维蛋白原消耗的影响:一项单中心队列研究

Impact of Pelvic Fracture Sites on Fibrinogen Depletion in Patients with Blunt Trauma: A Single-Center Cohort Study.

作者信息

Kunii Mayuko, Nakao Shunichiro, Nakagawa Yuko, Shimazaki Junya, Ogura Hiroshi

机构信息

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

出版信息

J Clin Med. 2022 Aug 11;11(16):4689. doi: 10.3390/jcm11164689.

Abstract

BACKGROUND

We aimed to examine the association of pelvic fracture sites with the minimum fibrinogen level within 24 h after hospital arrival.

METHODS

We conducted a single-center cohort study using health records review. We included patients with pelvic fractures transported by ambulance to a tertiary-care hospital from January 2012 to December 2018 and excluded those transported from other hospitals or aged younger than 16 years. The pelvic fracture was diagnosed and confirmed by trauma surgeons and/or radiologists. We classified the fracture sites of the pelvis as ilium, pubis, ischium, acetabulum, sacrum, sacroiliac joint diastasis, and pubic symphysis diastasis, and each side was counted separately except for pubic symphysis diastasis. We performed linear regression analysis to evaluate the association between pelvic fracture sites and the minimum fibrinogen level within 24 h of arrival.

RESULTS

We analyzed 120 pelvic fracture patients. Their mean age was 47.3 years, and 69 (57.5%) patients were men. The median Injury Severity Score was 24, and in-hospital mortality was 10.8%. The mean minimum fibrinogen level within 24 h of arrival was 171.4 mg/dL. Among pelvic fracture sites, only sacrum fracture was statistically significantly associated with the minimum fibrinogen level within 24 h of arrival (estimate, -34.5; 95% CI, -58.6 to -10.4; = 0.005).

CONCLUSIONS

Fracture of the sacrum in patients with pelvic fracture was associated with lower minimum fibrinogen levels within 24 h of hospital arrival and the requirement of blood transfusion.

摘要

背景

我们旨在研究骨盆骨折部位与入院后24小时内纤维蛋白原最低水平之间的关联。

方法

我们通过回顾健康记录进行了一项单中心队列研究。纳入2012年1月至2018年12月期间由救护车转运至三级医院的骨盆骨折患者,排除从其他医院转运而来或年龄小于16岁的患者。骨盆骨折由创伤外科医生和/或放射科医生诊断并确认。我们将骨盆骨折部位分为髂骨、耻骨、坐骨、髋臼、骶骨、骶髂关节分离和耻骨联合分离,除耻骨联合分离外,每侧分别计数。我们进行线性回归分析以评估骨盆骨折部位与入院后24小时内纤维蛋白原最低水平之间的关联。

结果

我们分析了120例骨盆骨折患者。他们的平均年龄为47.3岁,69例(57.5%)为男性。损伤严重程度评分中位数为24,院内死亡率为10.8%。入院后24小时内纤维蛋白原的平均最低水平为171.4mg/dL。在骨盆骨折部位中,只有骶骨骨折与入院后24小时内纤维蛋白原最低水平存在统计学显著关联(估计值为-34.5;95%置信区间为-58.6至-10.4;P=0.005)。

结论

骨盆骨折患者的骶骨骨折与入院后24小时内较低的纤维蛋白原最低水平及输血需求相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/273d/9409758/ec4e21d68af4/jcm-11-04689-g001.jpg

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