盆骨骨折急诊介入术后患者短期死亡的危险因素

目的分析盆骨骨折患者急诊介入术后短期死亡的危险因素。方法回顾性分析101例盆骨骨折患者的临床资料,根据患者治疗48h后的死亡情况分为生存组(65例)和死亡组(36例)。收集所有患者的年龄、身体质量指数(BMI)、住院时间、受伤至入院时间、24 h内平均输血量、性别、是否合并休克、损伤严重评分(ISS)、急性与慢性健康状况评分Ⅲ(APACHEⅢ)、是否合并头部损伤、是否合并四肢损伤、是否合并腹部损伤、盆骨外固定术、盆骨内固定术、最低氧合指数等资料。比较两组资料信息的差异,并将有差异的信息纳入Logistic模型,进行多因素Logistic回归分析。结果两组的年龄、BMI、住院时间、性别、是否合并四肢损伤、是否合并腹部损伤以及盆骨外固定术、盆骨内固定术患者比例比较,差异均无统计学意义(P>0.05)。死亡组受伤至入院时间≥1 h、24 h内平均输血量≥10U、合并休克、ISS≥25分、APACHEⅢ≥20分、合并头部损伤、最低氧合指数<200 mmHg的患者显著多于生存组(P<0.05)。经多因素Logistic回归分析证实,上述因素为盆骨骨折患者急诊介入术后短期死亡的危险因素(P<0.05)。结论临床医师应当密切关注盆骨骨折患者急诊介入术后发生短期死亡的危险因素,并及时予以相应的干预,以降低盆骨骨折患者的死亡率。

Objective To analyze the risk factors of short-term death in patients with pelvic fracture after emergency intervention.Methods The clinical data of 101 patients with pelvic fractures were retrospectively analyzed,and the patients were divided into survival group(65 cases)and death group(36 cases)according to their deaths after 48 hours of treatment.Collect all patients'age,body mass index(BMI),length of hospitalization,time from injury to admission,average blood transfusion volume within 24 hours,gender,whether combined with shock,injury severity score(ISS),acute and chronic health status Ⅲ(APACHE Ⅲ),whether it was combined with head injury,whether it was combined with limb injury,whether it was combined with abdominal injury,pelvic external fixation,pelvic internal fixation,minimum oxygenation index,etc.Compare the difierence between the two groups of data,and incorporate the difference information into the Logistic model,and perform multi-factor Logistic regression analysis.Results There was no significant difference in age,BMI,length of hospitalization,gender,whether combined with limb injury,whether combined with abdominal injury,and the proportion of patients undergoing pelvic external fixation and pelvic internal fixation between the two groups(P>0.05).In the death group,the time from injury to hospital admission was≥1 h,the average blood transfusion volume within 24 h was≥10 U,patients with shock,ISS≥25 points,APACHE Ⅲ≥20 points,head iry uries,and minimum oxygenation index<200 mmHg were significantly more than those in the death group Survival group(P<0.05).Multivariate logistic regression analysis confirmed that the above factors are risk factors for short-term death in patients with pelvic fractures after emergency intervention(P<0.05).Conclusion Clinicians should pay close attention to the risk factors of short-term death in patients with pelvic fractures after emergency intervention,and provide corresponding interventions in time to reduce the mortality of patients with pelvic fractures.