多创伤患者急性胃肠损伤个体化预测列线图的开发
Development of a nomogram for individualized prediction of acute gastrointestinal injury in polytrauma patients.
作者信息
Zhang Cong, Tang Zhaohui, Chang Teding, Chen Deng, Chen Shunyao, Zhang Peidong, Lin Zhiqiang, Pan Chunqiu, Luo Jialiu, Dong Liming
机构信息
Department of Trauma Surgery, Emergency Surgery & Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Trauma Surgery, Trauma Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510000, China.
出版信息
BMC Res Notes. 2024 Dec 23;17(1):378. doi: 10.1186/s13104-024-07066-2.
OBJECTIVE
Previous reports have indicated the occurrence of acute gastrointestinal injury (AGI) in critically ill individuals. Yet, there is limited information regarding the frequency and potential causes of AGI in individuals with polytrauma. The complicated diagnostic tools often mistaken and mislead the evaluation of AGI. The objective of this research is to create a nomogram that can predict the likelihood of AGI in individuals with polytrauma.
RESULTS
Among 836 polytrauma patients, AGI occurred in 61.2%, significantly higher than the 9.5% in monotrauma patients (P < 0.001).The predictors included Injury Severity Score (ISS) > 16, Glasgow Coma Scale (GCS) < 8, Acute Physiology and Chronic Health Evaluation II (APACHE II) > 16, Sequential Organ Failure Assessment (SOFA) > 5, presence of shock, lactate level > 3.2, and Activated Partial Thromboplastin Time (APTT) > 40 in the individualized prediction nomogram. The nomogram showed good discrimination (C-index = 0.719) and satisfactory calibration.
目的
既往报告指出危重症患者会发生急性胃肠损伤（AGI）。然而，关于多发伤患者中AGI的发生率及潜在病因的信息有限。复杂的诊断工具常常会错误判断并误导AGI的评估。本研究的目的是创建一种列线图，用于预测多发伤患者发生AGI的可能性。
结果
在836例多发伤患者中，AGI的发生率为61.2%，显著高于单处创伤患者的9.5%（P＜0.001）。在个体化预测列线图中，预测因素包括损伤严重程度评分（ISS）＞16、格拉斯哥昏迷量表（GCS）＜8、急性生理与慢性健康状况评分系统II（APACHE II）＞16、序贯器官衰竭评估（SOFA）＞5、休克的存在、乳酸水平＞3.2以及活化部分凝血活酶时间（APTT）＞40。该列线图显示出良好的区分度（C指数=0.719）和令人满意的校准度。
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