创伤指数在评估急性创伤住院患者病情及预后的应用研究  

Application of trauma index in the severity assessment and prognosis in hospitalized patients with acute trauma

作　　者：李兵[1] 阮海林[1] 葛文汉[1] 黄福文[1] 杨家有[1] 

机构地区：[1]广西医科大学第四附属医院急诊科,广西柳州545005

出　　处：《中国急救医学》2014年第1期71-74,共4页Chinese Journal of Critical Care Medicine

基　　金：卫生部公益性行业科研专项资助项目（201002014）;广西科学研究与技术开发计划项目（桂科攻1355005-6）

摘　　要：目的研究创伤指数（TI）在急性创伤住院患者病情评估和死亡预测中的应用价值。方法随机抽取急性创伤住院患者1802例，分别行创伤指数（TI）和损伤严重度评分（ISS）。以出院日期为观察终点，做出受试者工作特征（ROC）曲线，以ISS评分为参照，比较TI评分预测急性创伤住院患者结局的临床价值。结果TI评分ROC曲线下面积为0．896（95％C10．881—0．909），ISS评分ROC曲线下面积为0．792（95％C10．773～0．811），二者比较差异有统计学意义（Z=3．236，P=0．001）；判断急性创伤住院患者“潜在危重症”的最佳截断点分别为TI≥16分、ISSt〉22分；TI评分的敏感度优于ISS评分（P〈0．001），特异度、准确度与ISS评分比较差异无统计学意义（P〉0．05）。结论TI评分和ISS评分对急性创伤住院患者的结局预测均具有较高的分辨能力，并优于ISS评分；TI评分操作简便、易于掌握、反映病情及时可靠、适宜动态评估比较，有利于院内创伤危重症患者的早期发现与救治。Objective To evaluate the application value of trauma index （TI） in severity assessment and prognosis in hospitalized patients with acute trauma. Methods Made a research on the TI and the injury severity score（ISS） respectively by random sampling in hospitalized patients with acute trauma in 1802 cases. Receiver operator characteristic curve （ROC curve） was made by taking the date of discharge as the endpoint and the outcome as observed indicator. In order to compared TI in predicting prognosis value in hospitalized patients with acute trauma, ISS was for reference. Results The area under the ROC curve was 0. 896 （ 95% CI O. 881 - 0. 909 ） by the score of TI and 0. 792 （ 95% CI O. 773 -0. 811 ） by the score of ISS, there was statistically difference between the two （Z =3. 236 ,P = 0.001） ;the optimal truncation point to judge ＂the potential for critically ill patients＂ were TI ≥ 16, ISS≥22 respectively; The sensitivity of TI was superior to ISS （P 〈 0. 001 ）, the specificity and the accuracy of TI and ISS showed no significant difference （P 〉 0.05）. Conclusion TI and ISS both have high resolution in the condition assessment and death prediction for hospitalized patients with acute trauma, and is superior to ISS ; TI has the advantages of simple operation, being easy to learn, reflecting the condition timely and reliably, being suitable for dynamic evaluation and comparison, which is in favor of the early detection and treatment of hospital trauma patients with critical illness.

关 键 词：创伤指数(TI) 创伤 急性 住院患者 损伤严重度评分(ISS) 预后 

分 类 号：R641[医药卫生—外科学]