Analysis Of The Prognostic Factors For Discharging In Patients With Hemorrhagic Traumatic Shock Who Received Emergency Operation Under General Anesthesia

Objective: To determine the prognostic factors for discharging in patients with hemorrhagic traumatic shock who received emergency operation under general anesthesia in the first 24 hours admitted to the hospital and to explore the effective clinical intervention especially in the general anesthesia of the emergency operation.Methods: Check the patient cases in the first affiliated hospital of Nanchang University from January 2005 to May 2013 with first diagnosis of hemorrhagic shock included.Further select the cases that leading causes of shock was trauma and the patients experienced emergency operation under general anesthesia in the first 24 hours admitted in the hospital.The review data included patient characteristics,American Society of Anesthesiologist(ASA)physical status classification,anesthesia details,postoperative information,rescue measures of hospitalization and outcomes of discharging.Univariate and multivariate logistic regression analysis were used to determine prognostic factors associated with the outcome variable.P-values of less than 0.05 were considered statistically significant.Result: The outcomes at discharging were death(17/168,10.1%),survival with complications(46/168,27.4%),and survival without complications(105/168,62.5%).The prognostic factors associated with death and survival with complications were: attack time<6 hours(h)(OR=0.13,95.0% CI=0.03-0.56);pre-hospital volume treatment(OR=0.08,95.0% CI=0.01-0.90);ISS 17-25(OR=0.08,95.0% CI=0.01-0.77);always normal pressure(OR=0.01,95.0% CI=0-0.10);always SI<1(OR=0.21,95.0% CI=0.05-0.98);vasoactive drugs in operation(OR=4.05,95.0% CI=1.09-15.09);transfer to ICU after operation(OR=29.71,95.0% CI=1.78-496.45).Conclusion: Injury severity is a strong prognostic factor for discharging in patients with hemorrhagic traumatic shock who received emergency operation under general anesthesia in the first 24 hours admitted to the hospital.In addition,attack time,pre-hospital volume treatment,ISS scores,time of pressure return to normal range,shock redress time,vasoactive drugs in operation,transfer to ICU after operation.