A decision analysis of traumatic splenic injuries.
A decision analysis of traumatic splenic injuries.
复制标题
外伤性脾损伤的决策分析。
DOI：
10.1097/00005373-199209000-00002
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Helfand,M
中科院分区：
文献类型：
--
作者：
Feliciano,PD;Mullins,RJ;Trunkey,DD;Crass,RA;Beck,JR;Helfand,M
我们建立了一个创伤性脾损伤非手术治疗的决策分析模型，以阐明医院生存的风险，压倒性脾切除术后感染（OPSI）死亡，输血相关死亡。我们回顾了我院72例脾损伤病例，以确定成功观察（0.5个单位）、观察失败（1.0个单位）和手术脾处理（1.6个单位）的输血要求。使用我们的模型和从文献中确定的基线概率，我们比较了脾损伤的非手术治疗和立即剖腹手术，发现观察到住院生存率增加，但输血相关死亡的风险增加了两倍以上。两种策略的OPSI死亡率无显著差异。总体而言，我们发现决策分析有助于识别重要变量，如非治疗性剖腹手术死亡或漏诊损伤的概率，并澄清非手术治疗脾损伤与输血相关死亡和OPSI死亡的风险。
We created a decision analysis model of the nonsurgical management of traumatic splenic injuries to clarify the risk of hospital survival, overwhelming postsplenectomy infection (OPSI) deaths, and transfusion-related deaths. We reviewed 72 cases of splenic injury at our institution to identify our transfusion requirements for successful observation (0.5 units), observation failure (1.0 units), and surgical splenic management (1.6 units). Using our model and baseline probabilities determined from the literature, we compared the nonsurgical management of splenic injuries with immediate laparotomy and found an increase in hospital survival with observation, but an over two-fold increase in the risk of transfusion-related death. The OPSI deaths were not markedly different between the two strategies. Overall, we found decision analysis useful in identifying important variables such as the probability of nontherapeutic laparotomy death or missed injury, and in clarifying the risk of the nonsurgical management of splenic injuries with regard to transfusion-related deaths and OPSI deaths.