Characteristics and predictors of intensive care unit admission in pediatric blunt abdominal trauma.
Characteristics and predictors of intensive care unit admission in pediatric blunt abdominal trauma.
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小儿钝性腹部创伤的重症监护病房的特征和预测指标。
DOI：
10.1007/s00383-022-05067-5
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发表时间：
2022-04
影响因子：
1.8
通讯作者：
Vogel, Adam M.
中科院分区：
文献类型：
--
作者：
Mehl, Steven C.;Cunningham, Megan E.;Streck, Christian J.;Pettit, Rowland;Huang, Eunice Y.;Santore, Matthew T.;Tsao, Kuojen;Falcone, Richard A.;Dassinger, Melvin S.;Haynes, Jeffrey H.;Russell, Robert T.;Naik-Mathuria, Bindi J.;St Peter, Shawn D.;Mooney, David;Upperman, Jeffrey;Blakely, Martin L.;Vogel, Adam M.
小儿创伤患者常因钝性腹部创伤（BAT）合并腹腔内损伤（IAI）而入住重症监护室（ICU）。本研究旨在确定BAT后ICU入院的预测因素。前瞻性研究的儿童（< 16岁）谁提出了14个一级儿科创伤中心后，BAT超过1年的时间。患者分为ICU或非ICU患者。收集的数据包括生命体征、体格检查结果、实验室结果、成像和创伤性损伤。采用多变量分层逻辑回归模型确定ICU入院的预测因素。通过10倍交叉验证的受试者工作特征曲线下面积（cvAUC）评估模型的预测能力。包括2,182名儿童，其中21%（n = 463）入住ICU。在单因素分析中，ICU患者与年龄校正休克指数异常、损伤严重程度评分（ISS）升高、格拉斯哥昏迷评分（GCS）降低、创伤性脑损伤（TBI）和严重实体器官损伤（SOI）相关。多因素Logistic回归分析显示，严重创伤（ISS > 15）、贫血（红细胞压积< 30）、严重TBI（GCS < 8）、颈椎损伤、颅骨骨折和严重实体器官损伤是ICU入院的相关因素。多变量模型的cvAUC为0.91（95% CI 0.88-0.92）。严重的实体器官损伤和创伤性脑损伤，与多系统创伤相关，似乎是BAT儿科患者入住ICU的原因。这些结果可以为创伤室预测规则的设计提供信息，以帮助优化BAT后的ICU资源利用率。预后研究。1.
Pediatric trauma patients sustaining blunt abdominal trauma (BAT) with intra-abdominal injury (IAI) are frequently admitted to the intensive care unit (ICU). This study was performed to identify predictors for ICU admission following BAT. Prospective study of children (< 16 years) who presented to 14 Level-One Pediatric Trauma Centers following BAT over a 1-year period. Patients were categorized as ICU or non-ICU patients. Data collected included vitals, physical exam findings, laboratory results, imaging, and traumatic injuries. A multivariable hierarchical logistic regression model was used to identify predictors of ICU admission. Predictive ability of the model was assessed via tenfold cross-validated area under the receiver operating characteristic curves (cvAUC). Included were 2,182 children with 21% (n = 463) admitted to the ICU. On univariate analysis, ICU patients were associated with abnormal age-adjusted shock index, increased injury severity scores (ISS), lower Glasgow coma scores (GCS), traumatic brain injury (TBI), and severe solid organ injury (SOI). With multivariable logistic regression, factors associated with ICU admission were severe trauma (ISS > 15), anemia (hematocrit < 30), severe TBI (GCS < 8), cervical spine injury, skull fracture, and severe solid organ injury. The cvAUC for the multivariable model was 0.91 (95% CI 0.88–0.92). Severe solid organ injury and traumatic brain injury, in association with multisystem trauma, appear to drive ICU admission in pediatric patients with BAT. These results may inform the design of a trauma bay prediction rule to assist in optimizing ICU resource utilization after BAT. Prognosis study. 1.
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影响因子：
2.4
作者：
Hannan, EL;Farrell, LS;Cooper, A
通讯作者：
Cooper, A
影响因子：
2.4
作者：
COOPER, A;BARLOW, B;STRING, D
通讯作者：
STRING, D
影响因子：
4.1
作者：
Fremgen, Heather E.;Bratton, Susan L.;Barnhart, Douglas C.
通讯作者：
Barnhart, Douglas C.
影响因子：
2.4
作者：
TEPAS, JJ;MOLLITT, DL;BRYANT, M
通讯作者：
BRYANT, M
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DOI：
10.1016/j.injury.2015.06.002
发表时间：
2015-09-01
影响因子：
2.5
作者：
Kong, Guilan;Yin, Xiaofeng;Jiang, Baoguo
通讯作者：
Jiang, Baoguo