A prospective study of clinical characteristics and prognosis in patients with persistent inflammation, immunosuppression and catabolism syndrome after polytrauma
10.3760/cma.j.issn.1671-0282.2021.07.012
- VernacularTitle:多发伤并发持续炎症-免疫抑制-分解代谢综合征患者的临床特征及预后分析
- Author:
Tingxuan TANG
1
;
Cong ZHANG
;
Songbo LI
;
Zhenwen LI
;
Liangsheng TANG
;
Hai DENG
;
Han WU
;
Liming DONG
;
Zhaohui TANG
Author Information
1. 武汉科技大学医学院临床医学系1901 430081
- Keywords:
Polytrauma;
Persistent inflammation-immunosuppression and catabolism syndrome;
Clinical characteristics;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2021;30(7):862-865
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To prospectively assess clinical characteristics, potential causes and prognosis in patients with persistent inflammation, immunosuppression and catabolism syndrome (PICS) after polytrauma.Methods:Totally 1 083 patients with polytrauma admitted to Department of Traumatic Surgery of Tongji Hospital from Janury 2019 to July 2020 were enrolled. Exclusion criteria included age<18 years old, length of hospital stay<15 days, previous medical history of malignancy, or immunological, consumptive, and metabolic diseases. According to the diagnostic criteria of PICS, all enrolled patients were divided into two groups: PICS group and N-PICS group (without PICS). The patient’s clinical characteristics, ISS score, GCS score, SOFA score, and prognosis were collected. The χ2 test or Student’s t test was uesd to compare the difference between the PICS group and N-PICS group. Results:The incidence of PICS in patients with polytrauma was 11.7% (127/1 083). The majority of PICS patients were middle-aged and elderly men, 68.5% with traumatic brain injury and 59% with thoracic injury. GCS score was significantly lower, while ISS, APACHE II and SOFA scores were significantly higher in the PICS group than in the N-PICS group ( P<0.01, P<0.05). Among PICS patients, 79.5% were treated with mechanical ventilation and 76.3% were associated with pulmonary infection, with a 28-day mortality of 5.5% and a 180-day mortality of 16.5%, which were siginifcantly different from those without PICS. Conclusions:PICS has a high incidence after polytrauma and is commonly seen in middle-aged and elderly male patients with severe polytrauma, especially accompanied by traumatic brain injury or/and thoracic injury. Patients with PICS after polytrauma have poor long-term prognosis, so early identification and intervention should be strengthened in clinical practice.
