骨盆骨折对重度创伤患者院内结局的影响

doi:10.3969/j.issn.1002-1949.2018.10.013

Chinese Journal of Critical Care Medicine

2018, Vol. 38

Issue (10): 894-899 DOI: 10.3969/j.issn.1002-1949.2018.10.013

Effect of pelvic fracture on hospital outcome in patients with severe trauma

Zhang Yan-ying, Wang Zhen-liang, Sun Cheng-hong

Department of Spine Surgery, Ju′nan People′s Hospital, Linyi 276600, China

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Abstract Objective To evaluate the clinical features of patients with pelvic fractures and the influencing factors of pelvic fractures on in-hospital outcomes in patients with severe trauma. Methods A total of 293 patients with severe traumatic survival who were treated with orthopedic ICU in our hospital were selected. Patients were divided into pelvic fracture group (n=106) and non-pelvic fracture group (n=187) based on whether or not the patient had a pelvic fracture. Propensity score matching (PSM) was used to match patients according to age, gender and ISS score. The clinical characteristics and laboratory indicators of the two groups were compared. The clinical characteristics of pelvic fractures and the impact of pelvic fractures on hospital outcomes in patients with severe trauma were analyzed. Results A total of 170 patients were matched with 85 patients in each group. After matching, there was no difference in age, gender, ISS score, and cause of injury between the two groups (all P>0.05). However, length of ICU stay (t=10.800, P<0.001) and total length of stay (t=11.242, P<0.001) were significantly increased in patients with pelvic fractures. It suggested that the incidence of pelvic fractures is not affected by age, gender, injury mechanisms, and severity of injury, but pelvic fractures can result in serious in-hospital prognosis. At the same time, the transfusion rate was higher in the pelvic fracture group (χ2=8.479, P=0.004), and the multiple organ system dysfunction score (MODs), inflammatory response index, local hypoxia, and tissue hypoperfusion were all higher (all P<0.05). Conclusion Pelvic fractures can result in serious adverse outcomes in patients with severe trauma, but their incidence is not affected by age, gender, injury mechanisms, and severity of injury. At the same time, patients in the pelvic fracture group have higher blood transfusion rates, multiple organ dysfunction, inflammatory reactions, hypoxia, and hypoperfusion. Clinicians working in ICU should take corresponding first-aid measures according to the relevant characteristics of patients with pelvic fractures to improve and stabilize the overall status of patients in a timely manner.

Key words： Pelvic fracture In-hospital outcome Clinical features

About author:: Zhang Yan-ying, E-mail: jerryzhangsd@sohu.com

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Zhang Yan-ying,Wang Zhen-liang,Sun Cheng-hong. Effect of pelvic fracture on hospital outcome in patients with severe trauma[J]. Chinese Journal of Critical Care Medicine, 2018, 38(10): 894-899.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2018.10.013 OR http://www.cnemergency.org.cn/EN/Y2018/V38/I10/894

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