Birri Tanja, Pape Hans-Christoph, Dennler Cyrill, Simmen Hans-Peter, Vomela Jindrich, Chaloupka Richard, Mica Ladislav
Division of Trauma Surgery, University Hospital Zurich, 8091 Zurich, Switzerland.
Division of Medical Sciences in Sportsmedicine, Faculty of Sports Studies, Masaryks University, 62500 Brno, Czech Republic.
J Surg Res (Houst). 2022;5(4):626-631. doi: 10.26502/jsr.10020270. Epub 2022 Dec 15.
Polytrauma is a major cause of death in young adults. The trial was to identify clusters of interlinked anatomical regions to improve strategical operational planning in the acute situation. A total of 2219 polytrauma patients with an ISS (Injury Severity Score) ≥ 16 and an age ≥ 16 years was included into this retrospective cohort study. Pearson's correlation was performed amongst the AIS (Abbreviated Injury Scale) groups. The predictive quality was tested by ROC (Receiver Operating Curve) and their area under the curve. Independency was tested by the binary logistic regression, AIS ≥3 was taken as a significant injury. The analysis was conducted using IBM SPSS 24.0. The highest predictive value was reached in the combination of thorax, abdomen, pelvis and spine injuries (ROC: abdomen for thorax 0.647, thorax for abdomen 0.621, pelvis for thorax 0.608, pelvis for abdomen 0.651, spine for thorax 0.617). The binary logistic regression revealed the anatomical regions thorax, abdomen pelvis and spine as per-mutative independent predictors for each other when a particular injury exceeded the AIS ≥3. The documented clusters of injuries in truncal trauma are crucial to define priorities in the polytrauma management.
多发伤是青壮年死亡的主要原因。该试验旨在识别相互关联的解剖区域集群,以改善急性情况下的战略行动规划。本回顾性队列研究纳入了2219例损伤严重度评分(ISS)≥16且年龄≥16岁的多发伤患者。对简明损伤定级(AIS)组进行Pearson相关性分析。通过ROC(受试者工作特征曲线)及其曲线下面积检验预测质量。通过二元逻辑回归检验独立性,将AIS≥3视为严重损伤。使用IBM SPSS 24.0进行分析。胸部、腹部、骨盆和脊柱损伤组合的预测价值最高(ROC:腹部对胸部为0.647,胸部对腹部为0.621,骨盆对胸部为0.608,骨盆对腹部为0.651,脊柱对胸部为0.617)。二元逻辑回归显示,当特定损伤超过AIS≥3时,胸部、腹部、骨盆和脊柱等解剖区域彼此为置换独立预测因子。躯干创伤中记录的损伤集群对于确定多发伤管理的优先事项至关重要。