Risk factors for acute respiratory distress syndrome in patients with severe trauma

LIU Dongsheng; ZHANG Ting; WANG Man; LIU JunRong; LIU Hongsheng

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Risk factors for acute respiratory distress syndrome in patients with severe trauma

更新时间：2023-05-22

- Risk factors for acute respiratory distress syndrome in patients with severe trauma
- null Issue 9, Pages: 731(2019)
- 作者机构：
  
  1. 解放军总医院第四医学中心急救部,北京,100048
  2. 解放军总医院第五医学中心检验科,北京,100071
- 作者简介：
- 基金信息：
- DOI：
  CLC：
- Published：2019，
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LIU Dongsheng, ZHANG Ting, WANG Man, et al. Risk factors for acute respiratory distress syndrome in patients with severe trauma. [J]. null (9):731(2019)
DOI：

LIU Dongsheng, ZHANG Ting, WANG Man, et al. Risk factors for acute respiratory distress syndrome in patients with severe trauma. [J]. null (9):731(2019) DOI：

摘要

目的探讨严重创伤患者发生急性呼吸窘迫综合征(ARDS)的相关危险因素。方法回顾性分析解放军总医院第四医学中心急救部2010年6月至2017年6月收治的308例严重创伤患者的临床资料

根据患者是否患有ARDS将其分为观察组（77例发生ARDS）和对照组（231例未发生ARDS）；对比分析2组患者年龄、胸创伤严重程度评分(TTS)、基础性疾病、休克持续时间等。单因素分析和多因素分析判定严重创伤患者发生ARDS的危险因素。结果胸创伤的严重程度与ARDS的发生具有相关性，观察组机械通气率远高于对照组，差异有统计学意义(P＜0.05)。2组患者的肺部感染发生率、EICU及住院天数、死亡率比较，差异具有统计学意义(P＜0.05)。单因素分析显示，2组患者之间休克持续时间≥4 h、TTS评分≥14分、并发肺部感染和既往糖尿病史比较，差异具有统计学意义(P＜0.05)。Logistic回归分析示，TTS评分≥14分、休克持续时间≥4 h、入院时低氧血症是创伤后ARDS的危险因素(P＜0.01)，其中TTS评分≥14分是其高危因素(P＜0.01)。结论严重创伤患者发生ARDS与休克时间、TTS评分和入院时低氧血症相关。

Abstract

Objective To investigate the risk factors for acute respiratory distress syndrome (ARDS) in patients with severe trauma.Methods Clinical data of 308 severe trauma patients admitted to the emergency department of the fourth medical center of PLA general hospital from June 2010 to June 2017 were retrospectively analyzed.And the patients were divided into the observation group (77 cases) and the control group (231 cases) according to whether they suffered from ARDS.Age

thoracic trauma severity (TTS)

basic disease and shock duration were compared between the 2 groups.Univariate analysis and multivariate analysis were used to determine the risk factors of ARDS in patients with severe trauma.Results The severity of chest trauma is correlated with the occurrence of ARDS

and the mechanical ventilation rate in the observation group is much higher than that in the control group

with statistically significant difference (P<0.05).The incidence of pulmonary infection

length of EICU and hospital stay

and mortality of the two groups were statistically significant (P<0.05).Unifactorial analysis showed that shock duration greater than or equal to 4 hours

TTS score greater than or equal to 14 points

complicated with pulmonary infection

and previous history of diabetes were statistically significant between the two groups (P<0.05).Logistic regression analysis showed that TTS score greater than or equal to 14

shock duration greater than or equal to 4 hours and hypoxemia at admission were risk factors for ARDS after trauma (P<0.001)

among which TTS score greater than or equal to 14 was the high risk factor (P<0.01). ConclusionARDS in patients with severe trauma is associated with shock duration

TTS score and hypoxemia at admission.

关键词

严重创伤急性呼吸窘迫综合征危险因素相关性

Keywords

severe traumaacute respiratory distress syndromerisk factorscorrelation

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