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急性间隔综合征中的水疱形成:揭示潜在的预测因素。

Blister formation in acute compartment syndrome: Unraveling the underlying predictors.

机构信息

Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China.

Orthopaedic Research Institute of Hebei Province, Shijiazhuang, Hebei, P.R. China.

出版信息

Medicine (Baltimore). 2024 May 17;103(20):e38191. doi: 10.1097/MD.0000000000038191.

Abstract

Blisters are a common complication of orthopedic trauma and can cause surgery delay and increase the risk of infection. This study aims to identify risk factors for blisters in patients with acute compartment syndrome (ACS). Our study collected data from 206 ACS patients admitted to 2 hospitals between November 2013 and January 2021. Patients were divided into 2 groups: the blister group (BG) and the control group (CG), based on the presence or absence of blisters. We conducted univariate analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analysis to identify any significant differences in demographics, comorbidities, and admission laboratory test results between the 2 groups. Our study found that the incidence of blisters in ACS patients was 21.8% (45 out of 206). Univariate analysis identified several factors that were significantly associated with blister formation. Logistic regression analysis showed that patients who developed ACS in the winter or spring (P = .007, OR = 2.690, 95% CI [1.308-5.534]), patients who received a referral (the process whereby patients are transferred between medical facilities for further evaluation and treatment attempts prior to admission to our hospital) (P = .009, OR = 4.235, 95% CI [1.432-12.527]), and patients with higher PLR (P = .036, OR = 1.005, 95% CI [1.000-1.009]) were independent risk factors for blisters. Additionally, a history of drinking (P = .039, OR = 0.027, 95% CI [0.046-0.927]) was found to be a protective factor for blister formation in these patients. Moreover, ROC curve analysis showed that a PLR value of 138 was the cutoff point for predicting the development of blisters in ACS patients. Our study identified seasonal factors (refer to these months like winter or spring), referral, and patients with higher PLR as independent risk factors, and a history of drinking as a protective factor for blister formation in ACS patients. These findings allow clinicians to individualize the evaluation of blister risk and perform early targeted therapies.

摘要

水疱是骨科创伤的常见并发症,可导致手术延迟和增加感染风险。本研究旨在确定急性间隔综合征(ACS)患者水疱的危险因素。我们的研究收集了 2013 年 11 月至 2021 年 1 月期间 2 家医院收治的 206 例 ACS 患者的数据。根据是否存在水疱,将患者分为疱组(BG)和对照组(CG)。我们进行了单因素分析、逻辑回归分析和受试者工作特征(ROC)曲线分析,以确定两组之间在人口统计学、合并症和入院实验室检查结果方面是否存在任何显著差异。我们的研究发现,ACS 患者的水疱发生率为 21.8%(45/206)。单因素分析确定了几个与水疱形成显著相关的因素。逻辑回归分析显示,在冬季或春季发生 ACS 的患者(P=0.007,OR=2.690,95%CI[1.308-5.534])、接受转诊的患者(即患者在入院前在医疗机构之间转介以进行进一步评估和治疗尝试的过程)(P=0.009,OR=4.235,95%CI[1.432-12.527])和更高的 PLR(P=0.036,OR=1.005,95%CI[1.000-1.009])的患者是水疱的独立危险因素。此外,有饮酒史的患者(P=0.039,OR=0.027,95%CI[0.046-0.927])是 ACS 患者水疱形成的保护因素。此外,ROC 曲线分析显示,PLR 值为 138 是预测 ACS 患者发生水疱的截断点。我们的研究确定了季节因素(指冬季或春季等月份)、转诊和更高的 PLR 是独立的危险因素,而饮酒史是 ACS 患者水疱形成的保护因素。这些发现使临床医生能够对水疱风险进行个体化评估并进行早期靶向治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d14a/11098220/3f2157709c2b/medi-103-e38191-g001.jpg

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