摘要
目的分析老年严重创伤静脉系血栓的流行病学特征及其影响因素。方法回顾性研究,收集患者一般信息[性别、年龄、体质指数(BMI)]、受伤机制、损伤严重程度评分(ISS)、格拉斯哥昏迷评分(GCS)、凝血功能凝血酶原时间(PT)、国际标准化比值(INR)、D-二聚体、心房钠尿肽(BNP)、肝功能、肌酐、Caprini评分、手术策略、制动方式、住院床日、治疗费用等信息进行统计学分析。结果纳入179例老年严重创伤患者,其中男性130例(72.6%),年龄(67.6±6.4)岁。老年严重创伤患者的BMI为(22.9±3.4)kg/m^(2),ISS为(28.4±10.5)分,GCS评分为(10.2±4.6)分;Caprini评分为(11.7±4.0)分。其中,32例(17.9%)发生VTE事件。与VTE阴性组相比,VTE阳性组年龄大(t=-2.214,P=0.028),Caprini评分高(t=-2.684,P=0.008),下肢骨折(P=0.008)和骨盆骨折(P=0.001)发生率高。VTE阴性组与阳性组之间,凝血功能指标、肝功能指标、心房钠尿肽、肌酐、手术策略之间差异均无统计学意义(均P>0.05);两组之间,手术治疗占比差异无统计学意义(P=0.563)。VTE阳性组中无骨折占18.8%;1处骨折占50.0%,2处及以上骨折占31.2%,与VTE阴性组比较差异有统计学意义(P=0.029)。而VTE事件对老年创伤患者平均住院日和住院费用的影响无统计学意义(均P>0.05)。结论老年严重创伤中,高龄、高Caprini评分、骨折部位多和骨盆骨折患者容易发生VTE。骨盆骨折是老年创伤患者发生VTE的独立风险因素,应注意防治。
Objective To analyze the epidemiological characteristics and influencing factors of venous thrombosis in elderly patients with severe trauma.Methods A retrospective study was conducted to collect and statistically analyze general information[sex,age,body mass index(BMI)],causes of trauma,injury severity score(ISS),Glasgow coma score(GCS),coagulation function[prothrombin time(PT),international normalized ratio(INR),D-dimer],B-type natriuretic peptide(BNP),liver function(alanine aminotransferase,aspartate aminotransferase),creatinine,Caprini score,surgical approach,immobilization mode,days of hospitalization,and treatment cost.Results Totally 179 elderly patients with severe trauma were enrolled,including 130 men(72.6%),aged(67.6±6.4)years.The BMI,ISS and GCS scores of elderly patients with severe trauma were(22.9±3.4)kg/m^(2),28.4±10.5 and 10.2±4.6,respectively.The Caprini score was 11.7±4.0.Of these patients,32(17.9%)had VTE events.Compared with the VTE negative group,the VTE positive group was older(t=-2.214,P=0.028),with a higher Caprini score(t=-2.684,P=0.008)and more lower limb fractures(P=0.008)and pelvic fractures(P=0.001).There were no significant differences in coagulation function,liver function,atrial natriuretic peptide levels,creatinine levels and surgical approaches between the VTE negative group and the VTE positive group(all P<0.05).No significant difference was found in the proportion of patients receiving surgical treatment between the two groups(P=0.563).In the VTE positive group,18.8%had no fracture,50.0%had one fracture,and 31.2%had two or more fractures,and the difference was statistically significant compared with the VTE negative group(P=0.029).However,VTE events had no significant effect on the average length of stay and hospitalization costs in elderly trauma patients(all P<0.05).Conclusions For elderly patients with severe trauma,VTE is more likely to occur with increased age,a high Caprini score,multiple fracture sites and pelvic fracture.In addition,pelvic fracture is an independe
作者
芮强
沈嘉生
杨琦
徐杰
康洋波
于宝军
李雨林
许永安
Rui Qiang;Shen Jiasheng;Yang Qi;Xu Jie;Kang Yangbo;Yu Baojun;Li Yulin;Xu Yong'an(Department of Emergency Medicine,Jiaxing Second People's Hospital,Jiaxing 314000,China;Department of Emergency Medicine,the Second Affiliated Hospital of Zhejiang University School of Medicine&Institute of Emergency Medicine,Zhejiang University,Hangzhou 310009,China;Department of Emergency Medicine,Xinchang County People's Hospital,Shaoxing 312500,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2022年第10期1183-1186,共4页
Chinese Journal of Geriatrics
基金
国家自然科学基金项目(No.81571916、81372079、81201478)
浙江省医药卫生科技计划项目(No.2013KYA098、2016145610、2020KY577)。
