多发伤患者死亡的危险因素分析

Analysis of risk factors for death in patients with multiple injuries

目的:分析急诊多发伤患者死亡的相关因素及独立危险因素。方法:回顾性分析我院急诊科2017-01—2018-12期间救治的670例多发伤患者(其中46例死亡)的临床资料,根据患者的预后分为死亡组(46例),同时随机抽取同期多发伤生存患者60例(生存组),对2组患者性别、年龄、致伤原因、受伤部位,受伤至就诊时间、损伤程度评分法(ISS)评分、创伤数量、是否休克、输血量等指标进行比较,并采用Logistic回归分析患者死亡的独立危险因素。结果:死亡组在年龄≥60岁、高处坠落及车祸、颅脑损伤、受伤至就诊时间≥3h、ISS评分≥16分、创伤数量≥4处、休克、输血量≥4U的比例均高于生存组(均P<0.05)。其中,患者年龄≥60岁、受伤部位(颅脑)、受伤至就诊时间≥3h、ISS评分≥16分、休克为多发伤病患急诊死亡的独立危险因素。结论:上述独立危险因素应引起急诊医生的重点关注,并以此为依据制定急救预案可以降低多发伤患者的病死率。

Objective:To analyze the related factors and independent risk factors of death in patients with multiple trauma in emergency department.Method:The clinical data of 670 patients with multiple trauma(including46 deaths)who were in the emergency department of our hospital from January 2017 to February 2018 were retrospectively analyzed.According to the patient’s prognosis,the patients were divided into the death group(46 cases).At the same time,60 patients with multiple trauma patients(survival group)were randomly selected.The gender,age,cause of injury,injury site,injury to treatment time and degree of injury(ISS)scores,number of trauma,shock,blood transfusion,and other indicators were compared between the two groups.Logistic regression was used to analyze independent risk factors for death.Result:The rate of death group was higher than Survival group in the age of≥60 years old,falling and car accident,head injury,injury to treatment time≥3 h,ISS score≥16 points,number of trauma≥4,shock and blood transfusion≥4 U(both P<0.05).Among them,the patient was≥60 years old,the injured part(cranial brain),the time from injury to treatment was≥3 h,the ISS score was≥16,and shock was an independent risk factor for emergency death in patients with multiple injuries.Conclusion:The above independent risk factors should be be deserved the focusattention of by emergency doctors,and the development of emergency plans based on this these can reduce the mortality of patients with multiple injuries.