Analysis of clinical risk factors associated with mortality of severe trauma patients with acute lung injury
10.3760/cma.j.issn.1671-0282.2009.02.019
- VernacularTitle:影响严重创伤合并急性肺损伤的患者病死率危险因素分析
- Author:
Lei SHENG
;
Junsong WU
;
Yuefeng MA
;
Mao ZHANG
;
Shaowen XU
;
Guanyu JIANG
- Publication Type:Journal Article
- Keywords:
Trauma;
Acute lung injury;
Mortality;
Risk factors;
APACHE Ⅱ score
- From:
Chinese Journal of Emergency Medicine
2009;18(2):185-189
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify the potential risk factors affecting mortality rate of ALl in severe trauma population. Method It was a retrospective cohort study treating trauma as a single cause for emergency depart-ment (ED)) and emergency intensive care unit (EICU) admissions. Eighteen potential risk factors affecting the mortality of ALI were examined by univariate and multivariate logistic analyses in these severe trauma patients. Re-sults There were 343 severe trauma patients with post-traumatic ALI admitted to ED and EICU the Second Affili-ated Hospital Medical College,Zhejiang University,during the study period. The five risk factors that affected the mortality with unadjusted odd ratios (ORs) and 95% confidence intervals (CIs) were (1) APACHE Ⅱ score, (2)duration of trauma, (3) age, (4) aspiration of gastric contents, and (5) DIC. Specific risk factors also affected different patients subpepulations at different degrees. Conclusions Factors of APACHE Ⅱ score and aspiration of gastric contents that can predict the mortality of ALl may exist in the early stage of trauma. Duration of trauma and DIC that greatly affect the short- and long-term development of ALI deserve special attention. Elderly patients (aged beyond 65 years) are the independent risk factor for the secondary sepsis and deterioration of pulmonary function. Patients with these risk factors need aggressive supportive care as early as possible in order to prevent fur-ther aggravation.
