南疆地区因高处坠落伤入住创伤重症监护病房患者的临床特征及预后预测因素
Clinical features and prognostic predictors for patients admitted to trauma intensive care unit due to fall from height in South Xinjiang.
作者信息
Chen Yong, Li Wenwen, Wang Xiaohong, Zhong Qifu, Abudurexiti Alimujiang, Qiu Qinye, Li Jianwei, Luo Junyang
机构信息
Division of Trauma Intensive Care Unit 1, Trauma Center, The First People's Hospital of Kashi, 120 Yingbin Avenue, Kashi City, Xinjiang, 844000, P.R. China.
Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, P.R. China.
出版信息
Int J Emerg Med. 2025 Aug 4;18(1):142. doi: 10.1186/s12245-025-00959-4.
BACKGROUND
Falls from height (FFH) are a major cause of morbidity and mortality, accounting for a large proportion of trauma admissions to the intensive care unit (ICU).
PURPOSE
This study aims to summarize the clinical features and identify prognostic predictors associated with patients admitted to the trauma ICU due to FFH in south Xinjiang.
METHODS
This retrospective study was conducted from April 2020 to July 2024 and included patients admitted to the trauma ICU due to FFH. Clinical data were extracted and analyzed. Injury locations were classified into the head, spine, thorax, abdomen, pelvis, and extremities. Clinical outcomes included length of stay in the ICU, ventilator use, and in-hospital or 30-day mortality. Patients were followed up after discharge to record 30-day mortality. Independent predictors of mortality were calculated using a logistic regression model.
RESULTS
A total of 289 patients (mean age, 40.3 years ± 17.9; 225 males and 64 females) were enrolled in the study. The median height of the fall was 3 meters, with 26.6% (77/289) falling from ≥5 meters and 11.4% (33/289) falling from ≥10 meters. The median Injury Severity Score (ISS) was 24, with 63.3% (183/289) having an ISS greater than 20 and 41.5% (120/289) having an ISS greater than 25. Injuries involved ≥3 locations in 47.1% (136/289) of patients, ≥4 locations in 18.3% (53/289), and ≥5 locations in 7.6% (22/289). Mechanical ventilation was required for 36% (103/289) of patients, with an average ventilator duration of 103.5 (24–234) hours. The median length of ICU stay was 8 days (range: 1–132 days), and the overall in-hospital or 30-day mortality rate was 5.5% (16/289). The independent predictor of mortality was ISS (odds ratio, 1.07; 95% confidence interval: 1.003–1.14; = .04).
CONCLUSIONS
The Injury Severity Score is a predictor of in-hospital or 30-day mortality due to falls from height.
背景
高处坠落是发病和死亡的主要原因，在重症监护病房（ICU）的创伤入院病例中占很大比例。
目的
本研究旨在总结临床特征，并确定与新疆南部因高处坠落而入住创伤ICU的患者相关的预后预测因素。
方法
本回顾性研究于2020年4月至2024年7月进行，纳入因高处坠落而入住创伤ICU的患者。提取并分析临床数据。损伤部位分为头部、脊柱、胸部、腹部、骨盆和四肢。临床结局包括在ICU的住院时间、呼吸机使用情况以及院内或30天死亡率。患者出院后进行随访以记录30天死亡率。使用逻辑回归模型计算死亡率的独立预测因素。
结果
共有289例患者（平均年龄40.3岁±17.9；男性225例，女性64例）纳入研究。坠落的中位高度为3米，26.6%（77/289）的患者从≥5米高处坠落，11.4%（33/289）的患者从≥10米高处坠落。损伤严重程度评分（ISS）的中位数为24，63.3%（183/289）的患者ISS大于20，41.5%（120/289）的患者ISS大于25。47.1%（136/289）的患者损伤累及≥3个部位，18.3%（53/289）的患者累及≥4个部位，7.6%（22/289）的患者累及≥5个部位。36%（103/289）的患者需要机械通气，呼吸机平均使用时间为103.5（24 - 234）小时。ICU住院时间的中位数为8天（范围：1 - 132天），总体院内或30天死亡率为5.5%（16/289）。死亡率的独立预测因素是ISS（比值比，1.07；95%置信区间：1.003 - 1.14；P = .04）。
结论
损伤严重程度评分是高处坠落导致的院内或30天死亡率的预测因素。
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