严重创伤患者非计划转入急诊重症监护室的危险因素分析

Risk factors analysis of unplanned transfer to EICU in patients with severe trauma

目的探讨严重创伤(ST)患者非计划转入急诊重症监护室(EICU)的相关危险因素。方法回顾性分析2021年1月—2022年12月遵义医科大学附属医院急救创伤病房收治的231例ST患者住院资料,其中男性161人,女性70人;年龄14~85岁,平均(47.93±14.72)岁;道路交通伤125人,高坠伤42人,其他64人。根据ST患者有无非计划转入EICU将其分为未转组(197例)和转入组(34例),非计划转入EICU的ST患者占比14.72%;纳入指标包括性别,年龄,在急救创伤病房是否有手术及输血,受伤时间,创伤类型,损伤严重度评分(ISS),创伤部位,是否首诊,高血压,糖尿病。结果单因素分析显示,ST患者在急救创伤病房有手术(χ^(2)=3.925,P=0.048)、输血(χ^(2)=6.296,P=0.012)、高ISS(Z=-3.550,P<0.001)和有腹部创伤(χ^(2)=9.474,P=0.002)与非计划转入EICU相关;Logistic回归分析发现高ISS[OR=1.106,95%CI:1.025~1.193,P=0.010]、有腹部创伤[OR=2.662,95%CI:1.215~5.833,P=0.014]是ST患者非计划转入EICU的危险因素。结论高ISS、有腹部创伤是ST患者非计划转入EICU的危险因素。

Objective To explore the relevant risk factors for unplanned transfer of severe trauma(ST)patients to emergency intensive care unit(EICU).Methods A retrospective analysis was conducted on the hospitalization data of 231 ST patients admitted to the Emergency Trauma Ward of Zunyi Medical University Affiliated Hospital from January 2021 to December 2022,including 161 males and 70 females;Age range from 14 to 85 years old,with an average age of(47.93±14.72)years;125 people were injured by road traffic,42 people were injured by falling objects,and 64 others were injured.According to whether ST patients have unplanned transfers to EICU,they are divided into an untransferred group(197 cases)and a transferred group(34 cases).The proportion of ST patients who have unplanned transfers to EICU is 14.72%;Inclusive indicators include gender,age,whether there is operation and blood transfusion in the emergency trauma ward,injury time,injury type,injury severity score(ISS),injury site,whether there is first diagnosis,hypertension,diabetes.Results Single factor analysis showed that ST patients in the emergency trauma ward had surgery(χ^(2)=3.925,P=0.048)and blood transfusion(χ^(2)=6.296,P=0.012),high ISS(Z=-3.550,P<0.001),and abdominal trauma(χ^(2)=9.474,P=0.002),which were associated with unplanned transfer to EICU;Logistic regression analysis found that high ISS[OR=1.106,95%CI:1.025-1.193,P=0.010],and abdominal trauma[OR=2.662,95%CI:1.215-5.833,P=0.014]were risk factors for ST patients'unplanned transfer to EICU.Conclusion High ISS and abdominal trauma are risk factors for unplanned transfer of ST patients to EICU.