老年胸部创伤病人早期创伤性凝血病危险因素探讨

Risk factors of early traumatic coagulopathy in elderly patients with thoracic trauma

目的探讨老年胸部创伤病人早期创伤性凝血(TIC)的危险因素。方法2016年1月~2022年1月接诊的胸部创伤老年病人113例,依据病人是否发生早期TIC分为TIC组和非TIC组。利用单因素以及多因素Logistic回归分析对老年胸部创伤病人早期TIC的危险因素。利用多因素模型对老年胸部创伤病人早期TIC的预测价值进行分析。结果TIC组27例,非TIC86例。单因素分析结果显示,两组病人入院时的休克指数、血小板计数、血浆纤维蛋白比较差异有统计学意义(P<0.05)。多因素Logistic分析显示,入院时休克指数、血小板计数、血浆纤维蛋白均为老年胸部创伤病人早期TIC的独立影响因素(P<0.05)。多因素模型P值以及自变量对老年胸部创伤病人早期TIC进行预测,约登指数分别为36.95%、42.89%、75.58%、78.85%。结论入院时的休克指数、血小板计数、血浆纤维蛋白是老年胸部创伤病人早期TIC影响因素。

Objective To explore the risk factors of early traumatic coagulation(TIC)in elderly patients with chest trauma.Methods The data of 113 elderly patients with chest trauma admitted in a hospital from January 2016 to January 2022 were retrospectively analyzed.Patients were divided into TIC group and non⁃TIC group according to whether they had early TIC.The risk factors of early TIC in elderly patients with thoracic trauma were analyzed by single factor and multi factor methods.Analysis of the predictive value of early TIC in elderly patients with thoracic trauma using multifactor model.Result Of all the patients included in the study,27 were determined as TIC,and the rest 86 were non⁃TIC.The results of univariate analysis showed that there were statistically significant differences in the data of shock index,platelet count at admission and plasma fibrinogen at admission between patients in TIC group and non⁃TIC group(P<0.05).Multivariate analysis showed that the shock index at admission,platelet count at admission,and plasma fibrin at admission were all independent influencing factors of early TIC in elderly patients with chest trauma(all P<0.05).The P value of multivariate model and independent variables predict the early TIC of elderly patients with chest trauma.The Yoden index is 36.95%,42.89%,75.58% and 78.85% respectively.Conclusion The shock index,platelet count and plasma fibrin at the time of admission can affect the early occurrence of TIC in elderly patients with chest trauma.