钝性腹部主动脉损伤（BAAI）的医院死亡率：系统评价和荟萃分析。

BACKGROUND: Studies on the mortality of blunt abdominal aortic injury (BAAI) are rare and have yielded inconsistent results. In the present study, we aimed to quantitatively analyse the retrieved data to more accurately determine the hospital mortality of BAAI. METHODS: The Excerpta Medica Database, PubMed, Web of Science and Cochrane Library databases were searched to identify relevant publications without date restrictions. The overall hospital mortality (OHM) of BAAI patients was set as the primary outcome measure. English publications with data that met the selection criteria were included. The quality of all included studies was assessed by the Joanna Briggs Institute checklist and the American Agency for Health Care Quality and Research's cross-sectional study quality evaluation items. After data extraction, a meta-analysis of the Freeman-Tukey double arcsine transformation of data was performed using the Metaprop command in Stata 16 software. Heterogeneity was assessed and reported as a percentage using the I index value and as a P value using the Cochrane Q test. Various methods were used to determine the sources of heterogeneity and to analyse the sensitivity of the computation model. RESULTS: Of the 2147 references screened, 5 studies that involved 1593 patients met the selection criteria and were included. There were no low-quality references after assessment. One study that only included 16 juvenile BAAI patients was excluded from the meta-analysis of the primary outcome measure due to high heterogeneity. Due to the low heterogeneity (I = 47.6%, P = 0.126 for Q test) that was observed after using the random effects model, the fixed model was subsequently used to pool the effect sizes of the remaining four studies, thus yielding an OHM of 28.8% [95% confidence interval (CI) 26.5-31.1%]. The stability of the model was verified by sensitivity analysis, and Egger's test (P = 0.339) indicated a low level of publication bias. In addition, we also performed meta-analyses and obtained a pooled hospital mortality of operation (13.5%, 95% CI 8.0-20.0%), a pooled hospital mortality of non-operation (28.4%, 95% CI 25.9-31.0%), and a pooled rate of aortic rupture (12.2%, 95% CI 7.0-18.5%) of BAAI. CONCLUSIONS: The present study indicated that BAAI has an OHM of 28.8%, indicating that this disease deserves more attention and research.

背景：关于钝性腹主动脉损伤（BAAI）死亡率的研究很少，且结果不一致。本研究旨在通过定量分析检索到的数据，更准确地确定 BAAI 的院内死亡率。

方法：检索 Excerpta Medica 数据库、PubMed、Web of Science 和 Cochrane Library 数据库，无时间限制地检索相关文献。BAAI 患者的总体医院死亡率（OHM）为主要结局指标。纳入符合选择标准的英文出版物。使用 Joanna Briggs 研究所清单和美国医疗保健质量和研究机构的横断面研究质量评估项目评估所有纳入研究的质量。提取数据后，使用 Stata 16 软件中的 Metaprop 命令对数据进行 Freeman-Tukey 双反正弦变换的荟萃分析。使用 I 指数值表示异质性并报告百分比，使用 Cochrane Q 检验表示 P 值。使用各种方法确定异质性的来源，并分析计算模型的敏感性。

结果：在筛选的 2147 篇参考文献中，有 5 项研究共纳入 1593 例患者符合选择标准。评估后没有低质量的参考文献。由于高度异质性，有 1 项仅纳入 16 例青少年 BAAI 患者的研究被排除在主要结局指标的荟萃分析之外。由于使用随机效应模型后观察到低异质性（I=47.6%，Q 检验 P=0.126），随后使用固定模型汇总其余 4 项研究的效应量，从而得出 OHM 为 28.8%[95%置信区间（CI）26.5-31.1%]。通过敏感性分析验证了模型的稳定性，Egger 检验（P=0.339）表明发表偏倚程度较低。此外，我们还进行了荟萃分析，得出 BAAI 的手术死亡率（13.5%，95%CI 8.0-20.0%）、非手术死亡率（28.4%，95%CI 25.9-31.0%）和主动脉破裂率（12.2%，95%CI 7.0-18.5%）的汇总率。

结论：本研究表明，BAAI 的 OHM 为 28.8%，表明该病值得更多关注和研究。