三种休克指数对骨盆骨折伴休克患者预后的早期评估预测价值  

The three shock indexes in early predicting the prognosis of patients with pelvic fracture and shock

作　　者：汪洋[1] 鲁厚清[1] 邵仁德[1] 李贺[2] WANG Yang;LU Houqing;SHAO Rende;LI He(Department of Critical Care Medicine,Tongling People′s Hospital,Tongling 244000,China)

机构地区：[1]铜陵市人民医院重症医学科,安徽铜陵244000 [2]安徽医科大学第二附属医院重症医学科,安徽合肥230000

出　　处：《皖南医学院学报》2022年第3期235-238,共4页Journal of Wannan Medical College

基　　金：安徽省教育厅高校优秀人才支持计划项目(gxyq2021170)。

摘　　要：目的:探讨休克指数(SI)、改良休克指数(改良SI)、年龄休克指数(年龄SI)对骨盆骨折伴休克患者的临床意义和预后的预测价值。方法:回顾性分析铜陵市人民医院2013年9月1日~2020年12月30日ICU收住的骨盆骨折伴休克患者95例。根据预后情况分为存活组和死亡组。对SI、改良SI、年龄SI进行差异分析,并用ROC分析判断3种休克指数与死亡事件的关系。使用Kaplan-Meier法对存活患者的住院时间进行分析,判断不同休克指数能否显著影响住院时间。结果:95例患者中71例存活,24例死亡。死亡组的SI(1.91±0.17)、改良SI(2.64±0.37)、年龄SI(119.87±33.76)均高于存活组(1.66±0.39、2.27±0.58、84.45±28.94)(P<0.05)。ROC分析证实SI、改良SI和年龄SI对骨盆骨折伴休克患者的死亡事件有较好的预测效能,曲线下面积分别为0.744、0.712、0.797。SI、改良SI和年龄SI与存活患者的住院时间关联性均无统计学意义(P>0.05)。相关分析证实创伤严重度评分(ISS)与SI、改良SI、年龄SI均呈正相关(r=0.367、0.431、0.403,P<0.05)。结论:SI、改良SI、年龄SI都能预测骨盆骨折半休克患者的死亡事件,但年龄SI预测效能最好。当患者的年龄SI≥101时可能预示着不良后果。Objective:To investigate the clinical significance and value of shock index(SI),modified shock index(modified SI)and age shock index(age SI)in predicting the prognosis of patients with pelvic fracture and shock.Methods:Retrospective analysis was performed in 95 patients of pelvic fracture and shock admitted to the ICU in our hospital between September 1,2013 and December 30,2020.The cases were divided into survival group and death group according to the prognosis.SI,modified SI and age SI were analyzed for the differences in predicting the prognosis,and receiver operating characteristic(ROC)curve was developed to analyze the relationship of the three indexes with death events.Kaplan-Meier estimator was used to estimate the length of hospital stay of the survivals,and to determine whether different shock index would produce potential effect on hospital days.Results:Of the 95 cases included,71 were survivals and 24 deaths.SI,modified SI and age SI were generally higher in death group than in survival group(1.91±0.17;2.64±0.37;119±33.76 vs.1.66±0.39;2.27±0.58;84.45±28.94,respectively,all P<0.05).ROC analysis confirmed that SI,modified SI,and age SI had better efficiency in predicting the death event in patients of pelvic fracture with shock,and the area under ROC was 0.74,0.71,and 0.79,respectively.SI,modified SI,and age SI had no statistical significance in estimating the days of hospital stay in survivals(P>0.05),yet correlation analysis confirmed that injury severity score(ISS)was positively correlated with SI,modified SI,and age SI(r=0.367;0.431;0.403,respectively,P<0.05).Conclusion:SI,modified SI and age SI can predict the death of patients with pelvic fracture and shock.Of the three indexes,age SI represents the best predictor,and may be used to predict the adverse consequence in patients at the age SI≥101.

关 键 词：休克指数 骨盆骨折 休克 

分 类 号：R687.3[医药卫生—骨科学]