急诊腹部创伤患者MODS发生情况及其影响因素的Logistic回归分析

Logistic regression analysis of the occurrence of MODS and its influencing factors in emergency abdominal trauma patients

目的 探讨急诊腹部创伤患者多器官功能障碍综合征(MODS)发生情况并分析其影响因素。方法 回顾性选取2017年1月—2021年1月中国人民解放军联勤保障部队第904医院224例急诊腹部创伤患者的临床资料,统计住院期间MODS发生情况,并根据MODS发生与否分为MODS组与非MODS组,比较两组临床资料,采用Logistic回归分析MODS发生的相关影响因素,并采用受试者工作特征(ROC)曲线评价Logistic回归模型的预测价值。结果 急诊腹部创伤患者MODS发生率为44.64%(100/224);患者年龄、受伤至入院时间、直接脏器损伤、呼吸系统、神经系统、泌尿系统及消化系统功能损伤、全身炎症反应、AIS评分、ISS评分、APACHEⅡ评分均与急诊腹部创伤患者MODS的发生显著相关(P<0.05);采用Logistic回归模型预测急诊腹部创伤患者MODS发生风险的曲线下面积(AUC)为0.862,当Logistic(P)≤13.53时预测效能最佳,预测敏感度为86.00%,特异度为73.39%。结论 急诊腹部创伤患者的MODS发生率较高,MODS的发生受患者年龄、受伤至入院时间、直接脏器损伤等多种因素影响,早期采用Logistic回归模型可辅助预测MODS发生风险。

ObjectiveTo investigate the occurrence of multiple organ dysfunction syndrome(MODS)in emergency abdominal trauma patients and analyze its influencing factors.MethodsThe clinical data of 224 emergency abdominal trauma patients in the 904th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from January 2017 to January 2021 were retrospectively selected,the occurrence of MODS during hospitalization was counted,and the MODS group was divided into the MODS group and the non-MODS group according to whether the MODS occurred or not,and the two were compared.Group clinical data,using Logistic regression to analyze the related influencing factors of MODS,and using receiver operating characteristic(ROC)curve to evaluate the predictive value of Logistic regression model.ResultsThe incidence of MODS in emergency abdominal trauma patients was 44.64%(100/224);patient age,time from injury to admission,direct organ injury,respiratory system,nervous system,urinary system and digestive system functional damage,systemic inflammatory response,AIS Score,ISS score,and APACHEⅡscore were all significantly correlated with the occurrence of MODS in emergency abdominal trauma patients(P<0.05);the area under the curve(AUC)for predicting the risk of MODS in emergency abdominal trauma patients using Logistic regression model was 0.862,and when Logistic(P)≤13.53 the prediction efficiency was the best,the prediction sensitivity was 86.00%,and the specificity was 73.39%.ConclusionThe incidence of MODS in emergency abdominal trauma patients is relatively high.The occurrence of MODS is affected by the patient’s age,time from injury to hospitalization,direct organ damage,and other factors.Early use of Logistic regression model can help predict the risk of MODS.