Trauma with Injury Severity Score of 75: Are These Unsurvivable Injuries?
Trauma with Injury Severity Score of 75: Are These Unsurvivable Injuries?
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DOI：
10.1371/journal.pone.0134821
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发表时间：
2015-07-31
期刊：
影响因子：
3.7
通讯作者：
Xiang, Huiyun
中科院分区：
文献类型：
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作者：
Peng, Jin;Wheeler, Krista;Xiang, Huiyun
ISS=75的创伤患者被故意排除在一些创伤研究之外，因为他们被认为有“无法存活的损伤”。“这项研究旨在评估ISS=75的患者的真实死亡率，并检查这些患者的特征和初步诊断。对2006-2010年美国全国急诊科样本（NEDS）的回顾性审查产生了2，815例ISS=75的患者进行分析，估计该国有13，569例患者。这些患者的急诊科和医院处置按创伤中心水平制表。使用Pearson卡方检验比较存活者和非存活者。这些患者的主要诊断代码按死亡状态制表。总体而言，约48.6% ISS=75的患者存活出院，25.8%死亡，25.6%死亡状态未知。这些患者的死亡风险在不同级别的创伤中心之间没有显著差异（15.6% vs. 13.0%，P = 0.16）。非幸存者比幸存者更有可能：是男性（81.2%vs.74.4%，P < 0.0001），≥ 65岁（20.3%对10.2%，P < 0.0001），未投保（33.8% vs. 19.1%）、至少有一种慢性疾病（58.0% vs. 43.7%，P < 0.0001）、持续危及生命的损伤（79.2% vs. 49.4%，P
Trauma patients with an ISS=75 have been deliberately excluded from some trauma studies because they were assumed to have "unsurvivable injuries." This study aimed to assess the true mortality among patients with an ISS=75, and to examine the characteristics and primary diagnoses of these patients. Retrospective review of the 2006-2010 U.S. Nationwide Emergency Department Sample (NEDS) generated 2,815 patients with an ISS=75 for analysis, representing an estimated 13,569 patients in the country. Dispositions from the emergency department and hospital for these patients were tabulated by trauma center level. Survivors and non-survivors were compared using Pearson's chi-square test. Primary diagnosis codes of these patients were tabulated by mortality status. Overall, about 48.6% of patients with an ISS=75 were discharged alive, 25.8% died and 25.6% had unknown mortality status. The mortality risks of these patients did not vary significantly across different levels of trauma centers (15.6% vs. 13.0%, P = 0.16). Non-survivors were more likely than survivors to: be male (81.2% vs. 74.4%, P < 0.0001), be over 65 years (20.3% vs. 10.2%, P < 0.0001), be uninsured (33.8% vs. 19.1%), have at least one chronic condition (58.0% vs. 43.7%, P < 0.0001), sustain life-threatening injuries (79.2% vs. 49.4%, P