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创伤评分系统对结直肠损伤的预测效果评估

Evaluation of the predictive effects of trauma scoring systems in colorectal injuries.

作者信息

Altiok Merih, Tümer Haluk, Sarıtaş Ahmet Gökhan

机构信息

Department of General Surgery, Ortadoğu Hospital, 01250, Seyhan/Adana, Turkey.

Department of General Surgery, Seyhan State Hospital, Adana, Turkey.

出版信息

Eur J Trauma Emerg Surg. 2024 Feb;50(1):269-274. doi: 10.1007/s00068-023-02328-3. Epub 2023 Aug 9.

DOI:10.1007/s00068-023-02328-3
PMID:37555993
Abstract

INTRODUCTION

Colorectal injuries following traumas are significant causes of morbidity and mortality. This study aimed to evaluate the predictive effect of trauma scoring systems on mortality and morbidity in patients with post-traumatic colon injury.

METHODS

The records of 145 patients with colon trauma treated at Seyhan State Hospital between January 1, 2010, and January 1, 2020, were retrospectively analyzed. Injury Seriousness Score (ISS), Revised Trauma Score (RTS), Trauma Injury Severity Score (TRISS), and Colon Injury Score (CIS) scores were calculated for all patients. The predictive effects of scoring systems on primary outcomes of surgical treatment, complication rates, mortality, and anastomotic leaks were evaluated.

RESULTS

The mean age of the patients was 36.1 (SD ± 16.6), and the female/male ratio was 37/108. Anastomotic leakage occurred in 12 (8.2%) patients, and complications were observed in 57 (39.3%) patients. Seven (4.7%) patients died. A statistically significant relationship was observed between the increase in CIS and anastomotic leakage, morbidity, and mortality. Increases in ISS and decreases in RTS and TRISS were associated with increased morbidity and mortality, but these relationships were not statistically significant.

CONCLUSION

A significant relationship was observed between the increase in CIS and anastomotic leakage, morbidity, and mortality. The study suggests the need for a specific scoring system for evaluating the prognostic status in colon traumas, as ISS, RTS, and TRISS scores were not found to be significantly predictive of outcomes in this patient population.

摘要

引言

创伤后结直肠损伤是发病和死亡的重要原因。本研究旨在评估创伤评分系统对创伤后结肠损伤患者死亡率和发病率的预测作用。

方法

回顾性分析2010年1月1日至2020年1月1日在塞伊汉州立医院接受治疗的145例结肠创伤患者的记录。计算所有患者的损伤严重度评分(ISS)、修订创伤评分(RTS)、创伤损伤严重度评分(TRISS)和结肠损伤评分(CIS)。评估评分系统对手术治疗的主要结局、并发症发生率、死亡率和吻合口漏的预测作用。

结果

患者的平均年龄为36.1岁(标准差±16.6),男女比例为37/108。12例(8.2%)患者发生吻合口漏,57例(39.3%)患者出现并发症。7例(4.7%)患者死亡。观察到CIS升高与吻合口漏、发病率和死亡率之间存在统计学显著关系。ISS升高以及RTS和TRISS降低与发病率和死亡率增加相关,但这些关系无统计学显著性。

结论

观察到CIS升高与吻合口漏、发病率和死亡率之间存在显著关系。该研究表明,由于未发现ISS、RTS和TRISS评分对该患者群体的结局有显著预测作用,因此需要一种特定的评分系统来评估结肠创伤的预后状况。

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Indications for and outcome of primary repair compared with faecal diversion in the management of traumatic colon injury.创伤性结肠损伤中一期修复与粪便转流术治疗的适应证和结局比较。
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World J Emerg Surg. 2015 May 12;10:21. doi: 10.1186/s13017-015-0014-9. eCollection 2015.
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A prospective observational study of abdominal injury management in contemporary military operations: damage control laparotomy is associated with high survivability and low rates of fecal diversion.一项关于当代军事行动中腹部损伤处理的前瞻性观察研究:损伤控制性剖腹术与高存活率和低粪便转流率相关。
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Applicability of an established management algorithm for colon injuries following blunt trauma.已建立的钝性创伤后结肠损伤管理算法的适用性。
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