BACKGROUND & AIMS:
BACKGROUND:Prognostic factors affecting mortality and morbidity in thoracoabdominal injuries were evaluated.
METHODS:Two hundred and fifty patients (227 males, 23 females; mean age 30.1+/-5.11; range 15 to 71 years) who had been exposed to thoracoabdominal injuries and underwent laparotomy between June 1996 and November 2005 were investigated retrospectively. Patients were assessed according to age, sex, trauma-operation interval, shock, hospitalization period, number of injured organs, blood transfusion, timing of closed thorax drainage, thoracotomy, Abdominal Trauma Index, Injury Severity Score, Abbreviated Injury Score, Revised Trauma Score, and complications.
RESULTS:Mortality and morbidity ratios were 15.6% and 53.5%, respectively. The factors effective on mortality were trauma-operation interval >or=3 hours (p=0.03), presence of shock (p=0.03), increase in the rate of blood transfusion (p=0.001), injured organ number >or=3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005). Trauma-operation interval <3 (p=0.02), increase in the rate of blood transfusion (p=0.02), injured organ number >or=3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005) were the factors effective on morbidity.
CONCLUSION:It was determined that trauma-operation period >or=3 hours, number of injured organs >or=3, and increased number of blood transfusions increased both mortality and morbidity. However, presence of shock increased only mortality. On the other hand, application of closed thorax drainage within a reasonable time period was determined to decrease mortality and morbidity.
背景与目标:
背景:评估影响胸腹损伤死亡率和发病率的预后因素。
方法:回顾性分析1996年6月至2005年11月间接受胸腹损伤并剖腹手术的患者250例(男227例,女23例;平均年龄30.1 /-5.11;年龄15至71岁)。根据年龄,性别,创伤手术间隔,休克,住院时间,受伤器官的数量,输血,闭合胸腔引流的时间,开胸手术,腹部创伤指数,损伤严重度评分,简化损伤评分,修订的创伤评分对患者进行评估和并发症。
结果:死亡率和发病率分别为15.6%和53.5%。影响死亡率的因素有:创伤手术间隔>或= 3小时(p = 0.03),休克存在(p = 0.03),输血率增加(p = 0.001),受伤器官数目> or = 3 (p = 0.001),并且未进行早期的封闭胸腔引流(p = 0.005)。创伤手术间隔<3(p = 0.02),输血率增加(p = 0.02),受伤器官数目> or = 3(p = 0.001),并且不进行早期的封闭胸腔引流(p = 0.005)是对发病有效的因素。
结论:确定创伤手术时间≥3小时,受伤器官数目≥3小时,输血次数增加,死亡率和发病率均增加。但是,休克的存在只会增加死亡率。另一方面,确定在合理的时间段内应用封闭的胸腔引流可降低死亡率和发病率。