PROGRESS IN CHARACTERIZING ANATOMIC INJURY
PROGRESS IN CHARACTERIZING ANATOMIC INJURY
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DOI：
10.1097/00005373-199010000-00003
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发表时间：
1990-10-01
影响因子：
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通讯作者：
SCHWAITZBERG, S
中科院分区：
文献类型：
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作者：
COPES, WS;CHAMPION, HR;SCHWAITZBERG, S
提出了解剖损伤的三值描述。解剖剖面 (AP) 组件 A、B 和 C 总结了头部/大脑或脊髓的严重损伤 (> AIS 2)；到胸部或颈部前部；以及所有剩余的重伤。 AP 成分与生存率之间的关系再次证实了头部损伤的严重性。将 AP 组成部分和损伤严重程度评分 (ISS) 与生存概率相关的逻辑函数模型基于 1986 年提交的 20,946 名重大创伤结果研究 (MTOS) 患者（死亡率 9.2%）。模型性能比较基于 1987 年提交的 5,939 名 MTOS 患者（死亡率 7.8%）。AP 更好地区分幸存者与非幸存者，并且在以下情况下灵敏度提高了 31%：与国际空间站相比。仅 ISS 和 AP 都不能可靠地预测患者的结果。估计患者生存概率的方法（包括生理指标或概况、患者年龄和解剖学概况）的预测能力应与现有方法进行比较。 AP 基于所有严重伤害的严重程度和位置，为比较患者样本提供了比 ISS 更合理的基础。
A three-valued description of anatomic injury is presented. Anatomic profile (AP) components A, B, and C summarize serious injuries (> AIS 2) to the head/brain or spinal cord; to the thorax or front of the neck; and all remaining serious injuries. Relationships between AP components and survival rate reaffirm the seriousness of head injury. Logistic function models relating AP components and the Injury Severity Score (ISS) to survival probability were based on 20,946 Major Trauma Outcome Study (MTOS) patients (9.2% mortality rate) submitted through 1986. Model performance comparisons were based on 5,939 MTOS patients (7.8% mortality rate) submitted during 1987. The AP better discriminated survivors from nonsurvivors and provided a 31% increase in sensitivity when compared with the ISS. Neither the ISS nor the AP alone reliably predict patient outcome. The predictive power of methods for estimating patient survival probability which include physiologic indices or profiles, patient age, and an anatomic profile should be compared with current methods. The AP, which is based on the severity and location of all serious injuries, provides a more rational basis for comparing patient samples than the ISS.