Epidemiological Characteristics Of Severe Chest Trauma Patients With Multiple Injuries

Objective: Analyze the epidemiological characteristics and risk factors of death in patients with severe chest trauma complicated with multiple injuries,so as to provide further reference for the successful treatment of patients with SCT complicated with multiple injuries.Methods: The medical records of patients with SCT complicated with multiple injuries from January 2019 to April 2020 in the emergency intensive care unit of the Third Hospital of Hebei Medical University were retrospectively collected.The basic information,injury-admission status,hospital treatment and prognosis of the patients were analyzed and compared.At the same time,the above factors were analyzed by univariate and multivariate logistic regression analysis to obtain the independent risk factors of death.ROC curve was drawn and AUC was calculated to evaluate the prediction efficiency.Data were analyzed by SPSS 24.0.Results:1.Epidemiological characteristicsThere were 119 patients in the early treatment group.15 cases(12.61%)were first diagnosed in our hospital and 104 cases(87.39%)were transferred from other hospitals.There were 93 males(78.15%)and 26 females(21.85%).The age ranged from 14 to 84 years old,with a median of 50(37,63)years old.The highest occupation is farmers.Trauma incidents often occur in the time from 8 o’clock to 11 o’clock and from 15 o’clock to 20 o’clock.The most common injury mechanism was road traffic injury(75/119,63.03%).All the chest injuries were blunt thoracic trauma.The most common chest injury was pulmonary contusion/laceration(100%),followed by rib fracture(85/119,71.43%).The most common combined injury sites were lower limbs and pelvis(79/119,66.39%).The median of injury severity score was 29(25,36)points.The median of Glasgow Coma Scale was 12(5,15)points.The median of thoracic trauma severity score was 9(7,11)points.The median of Acute Physiology and Chronic Health Evaluation II was 13(8,20)points.38 patients(31.93%)underwent emergency surgery within 24 hours after admission.84patients(70.59%)underwent elective surgery.The most common complications were respiratory failure(39.5%),pulmonary infection(37.82%)and shock(51.26%).There were 20(16.81%)deaths finally.2.Risk factors of deathISS,APACHEⅡ and vasoactive drugs were independent risk factors of death in patients with SCT complicated with multiple injuries.The AUC of ISS,APACHEⅡ and combined death prediction probability were 0.808,0.845 and 0.904 respectively,and the best critical points were 31.5,22.5 and0.319 respectively.Conclusions:1.Severe chest trauma combined with multiple injuries was more likely to occur in the working-age group.Traffic accidents and industrial production were the main causes of multiple injuries.2.The use of vasoactive drugs,higher ISS score and APACHE II score were independent risk factors of death in patients with severe chest trauma combined with multiple injuries.