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土耳其地震后挤压综合征的死亡风险因素:全身炎症参数是否起作用?

Mortality risk factors for crush syndrome after an earthquake in Türkiye: Do systemic inflammatory parameters play any role?

机构信息

Department of Anesthesiology and Reanimation, Cukurova University Faculty of Medicine, Adana-Türkiye.

Department of Internal Medicine, Cukurova University Faculty of Medicine, Adana, Türkiye -Türkiye.

出版信息

Ulus Travma Acil Cerrahi Derg. 2024 Aug;30(8):588-595. doi: 10.14744/tjtes.2024.09637.

Abstract

BACKGROUND

The aim of our study is to assess the prognostic impact of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) on 28-day mortality in patients admitted to the intensive care unit with crush syndrome following the Kahramanmaraş earthquake in Türkiye.

METHODS

A total of 63 adult patients with crush syndrome admitted to the intensive care unit after the earthquake were enrolled in this study. The medical records of the patients were examined using follow-up forms and the hospital data system.

RESULTS

The mean age of the patients was 38.9±17.3 years, and the median time under debris was 31.5 hours. The 28-day mortality rate was 27%. In univariate generalized estimating equations (GEE) and other analyses, variables that are significant (or candidate variables) between 28-day mortality groups included age as a biological factor. These variables were included in the multivariate GEE model. The effects of continuous renal replacement therapy (CRRT), serum sodium concentration, Sequential Organ Failure Assessment (SOFA) score, and PLR on mortality were statistically significant.

CONCLUSION

Elevated SOFA scores, the necessity for CRRT, increased serum sodium levels, and decreased PLR values are associated with increased 28-day mortality in patients with crush syndrome after an earthquake.

摘要

背景

我们的研究旨在评估中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)和血小板与淋巴细胞比值(PLR)对土耳其卡赫拉曼马拉什地震后入住重症监护病房的挤压综合征患者 28 天死亡率的预后影响。

方法

本研究共纳入 63 例地震后入住重症监护病房的挤压综合征成年患者。使用随访表和医院数据系统检查患者的病历。

结果

患者的平均年龄为 38.9±17.3 岁,被埋压时间中位数为 31.5 小时。28 天死亡率为 27%。在单变量广义估计方程(GEE)和其他分析中,28 天死亡率组之间有显著差异的变量(或候选变量)包括作为生物学因素的年龄。这些变量被纳入多变量 GEE 模型。连续肾脏替代治疗(CRRT)、血清钠浓度、序贯器官衰竭评估(SOFA)评分和 PLR 对死亡率的影响具有统计学意义。

结论

地震后挤压综合征患者的 SOFA 评分升高、需要 CRRT、血清钠水平升高和 PLR 值降低与 28 天死亡率增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17a7/11372493/56624060e071/TJTES-30-588-g001.jpg

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