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| 1 | What factors affect length of hospital stay among trauma patients? A single-center study, Southwestern Iran显示文摘Purpose: Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patients in a trauma center in Southwestern Iran.Methods: This cross-sectional study was conducted on patients admitted to Rajaee Trauma Center, Shiraz, Iran between January 1, 2018 and December 30, 2018. The inclusion criteria were age above 15 years and having traffic accident injuries, including car, motorcycle and pedestrian injury mechanisms. The exclusion criteria were existing diseases including cardiovascular, cerebral, renal, and pulmonary diseases prior to this study, dead upon arrival or within 48 h after admission, and stay at the hospital for less than 6 h. The risk variables analyzed for prolonged LOS were age, gender, mechanism of traffic accident injury, infection during hospital stay, type of injury, injury severity score, surgery during hospitalization, and survival. Poisson regression was performed to evaluate the partial effects of each co- variate on trauma hospitalization (≥3 days as longer stay).Results: This study was conducted on 14,054 patients with traffic accident injury and the mean age was (33.89 ± 15.78) years. Additionally, 74.35% of the patients were male, with male to female ratio of 2.90. The result of Poisson regression indicated that male patients, higher age, combination of thoracic injuries, onset of infected sites, and surgery patients were more susceptible to have a longer LOS. Considering the site of injury, patients with face injuries followed by those with thorax injuries had the highest means of LOS (3.74 days and 3.36 days, respectively). Simultaneous existence of surgical inter- vention and infection in a patient had the greatest impact on prolonged LOS.Conclusion: This study identified that age, gender, mechanism of injury, infection, type of injury, survival, and ISS could lead to prolongation of LOS, but the affect can be reduced by eliminating modifiable risk factors. | Ali Kashkooe Mahnaz Yadollahi Forough Pazhuheian | 2020 | Chinese Journal of Traumatology2020，23，3： | 6 |
| 2 | 660例创伤患者肺部感染的危险因素分析显示文摘目的:探索创伤患者肺部感染的危险因素及其对预后的影响,指导临床救治,改善疗效。方法:回顾性分析2016年1月—2018年1月期间660例创伤患者的临床资料,其中男497例,女163例。采用Logistic回归分析创伤患者肺部感染对预后(28d死亡事件)的影响及相关危险因素。结果:660例患者中,共有124例发生肺部感染(18.8%),536例未发生肺部感染(81.2%)。28d死亡病例为46例(6.96%),其中肺部感染患者35例(28.23%)显著高于非肺部感染组11例(2.05%)(P<0.01),肺部感染是创伤患者死亡的重要独立危险因素(OR=12.83,95%CI:5.70~28.89,P<0.01)。多因素Logistic回归分析提示年龄(OR=1.02,95%CI:1.01~1.03,P=0.001)、严重损伤[损伤严重程度评分(ISS)≥16](OR=6.86,95%CI:3.87~12.16,P<0.01)、胸部损伤(OR=2.54,95%CI:1.20~5.37,P=0.015)、急诊手术(OR=2.21,95%CI:1.35~3.61,P=0.002)和收入ICU(OR=2.43,95%CI:1.21~4.86,P=0.013)是创伤患者发生肺部感染的独立危险因素。结论:创伤患者发生肺部感染与年龄、ISS≥16、发生胸部损伤、接受急诊手术和入住ICU等因素密切相关,有效预防和治疗肺部感染是改善创伤患者预后的重要环节。 | 黄利民 冯志书 陈慧敏 杨志洲 聂时南 | 2021 | 临床急诊杂志2021，22，1： | 3 |
| 3 | 负压封闭引流联合创面修复生物凝胶在老年创伤性感染护理干预中的疗效观察显示文摘目的探讨负压封闭引流技术(vaccum sealing drainage,VSD)联合创面修复生物凝胶在老年创伤性感染护理干预中的应用效果。方法选取2017年1月至2019年12月在南京市第一医院收治的60例老年创伤性感染病人为研究对象,按护理干预方法不同分为对照组(n=30)和观察组(n=30)。对照组接受外科清创术等常规治疗措施,并实施VSD治疗,观察组在对照组基础上联合创面修复生物凝胶治疗,观察并比较2组炎症因子IL-6、CRP和IL-17水平以及创面面积变化和疗效。结果入院护理干预第14天,观察组IL-6、CRP和IL-17水平明显低于对照组,差异有统计学意义(t=8.399,5.060,12.490,均P<0.01)。2组护理干预第7天与第1天比较,创伤面积差异均有统计学意义(t=6.669,7.194,均P<0.01);护理干预第7天,2组创面面积比较,差异无统计学意义(t=1.303,P>0.05);2组护理干预第14天和第21天创面面积比较,差异有统计学意义(t=3.265,5.574,均P<0.01)。观察组病人临床护理干预总有效率为93.3%,显著高于对照组的73.3%,差异有统计学意义(P<0.05)。结论VSD联合创面修复生物凝胶治疗策略可显著控制老年创伤性感染病人体内炎症因子水平,提高治愈率。 | 张梅 秦素萍 | 2021 | 实用老年医学2021，35，6： | 2 |
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