ICU中创伤死亡相关问题的研究现状

Current opinion on risk factors related to the mortality of trauma patients in ICU

重症监护室(ICU)是提高严重创伤患者救治效果的重要场所,了解与患者死亡相关的危险因素对于提高创伤的救治水平具有重要意义。目前ICU中创伤患者的病死率为10.4%～19.0%。创伤的严重程度直接影响患者的病死率,但至今还没有非常理想的创伤评分系统。患者的基础条件如肥胖和过度消瘦等是导致预后不佳的危险因素。血糖管理、创伤后感染的防控等治疗相关措施也影响患者的预后。此外,ICU内创伤患者的自动出院问题容易被忽视,会影响创伤救治效果的正确评估,需要引起重视。

Intensive care unit（ICU） is an important place where we could improve the outcome of severe trauma patients.Better understanding of risk factors related to the mortality of severe trauma patients in ICU could help to improve the quality of care.Many researches have implied that the mortality of trauma patients in ICU varies between 10.4%-19%.Severity of injuries directly affects the prognosis of trauma patients.However,there has not been a rational scoring system yet.Patients＇ own conditions such as aging,male,polarized body mass index,are also correlated with worse outcomes and higher mortalities.Various therapeutic measures including control of blood glucose,prevention and control of infection could also influence the outcome of trauma patients.Discharge against medical advice is usually ignored,which makes correct evaluation of trauma care be impossible and deserves more attention.