CAJ | 학술논문

目的获取中国汉族创伤患者ISS和新ISS(NISS)的半数致死量(LD50)并探讨其对创伤后并发症及死亡结局的预测价值. 方法对来源于中华创伤数据库收录的6 542例汉族创伤患者进行Probit回归分析,获取ISS和NISS在不同年龄段的LD50值.再利用ISS、NISS、ISSLD50ISS和NISS LD50NISS对来源于大坪医院的1 148例汉族创伤患者并发症及死亡结局进行预测.根据受试者工作特征曲线(ROC)评价预测能力.通过DeLong-DeLong非参数法比较ROC曲线下面积(AUC)评估各指标的预测价值. 结果 16 ～44岁、45～ 64岁和≥65岁三个年龄段ISSLD50值(LD50ISS)分别为55,49和33;NISS的LD50值(LD50NISS)分别为62,56和43.在预测ARDS、MODS时,ISS/LD50ISS和NISS/LD50NISS的AUC大于单独应用ISS和NISS(P＜0.05),具有更高的预测价值.在预测脓毒症时,ISS/LD50ISS和NISS/LD50NISS与单独应用ISS和NISS具有相同的预测价值.在预测死亡时,ISS/LD50ISS和NISS/LD50NISS的AUC均＞0.9(分别为0.907和0.903),表现出较高的预测价值. 结论本研究提出中国汉族不同年龄段创伤患者ISS和NISS的LD50值,可作为早期预测创伤后ARDS、MODS和死亡结局的新方法.
목적 획취중국한족창상환자ISS화신ISS(NISS)적반수치사량(LD50)병탐토기대창상후병발증급사망결국적예측개치. 방법 대래원우중화창상수거고수록적6 542례한족창상환자진행Probit회귀분석,획취ISS화NISS재불동년령단적LD50치.재이용ISS、NISS、ISSLD50ISS화NISS LD50NISS대래원우대평의원적1 148례한족창상환자병발증급사망결국진행예측.근거수시자공작특정곡선(ROC)평개예측능력.통과DeLong-DeLong비삼수법비교ROC곡선하면적(AUC)평고각지표적예측개치. 결과 16 ～44세、45～ 64세화≥65세삼개년령단ISSLD50치(LD50ISS)분별위55,49화33;NISS적LD50치(LD50NISS)분별위62,56화43.재예측ARDS、MODS시,ISS/LD50ISS화NISS/LD50NISS적AUC대우단독응용ISS화NISS(P＜0.05),구유경고적예측개치.재예측농독증시,ISS/LD50ISS화NISS/LD50NISS여단독응용ISS화NISS구유상동적예측개치.재예측사망시,ISS/LD50ISS화NISS/LD50NISS적AUC균＞0.9(분별위0.907화0.903),표현출교고적예측개치. 결론 본연구제출중국한족불동년령단창상환자ISS화NISS적LD50치,가작위조기예측창상후ARDS、MODS화사망결국적신방법.
Objective To obtain the lethal dose 50 (LD50) of injury severity score (ISS) and new injury severity score (NISS) for Chinese Han trauma patients at different ages and investigate the predictive value of the two for complications or mortality in trauma patients.Methods Data of 6,542 Chinese Han trauma patients from Chinese Trauma Databank were analyzed using Probit regression to obtain the LD50 of ISS and NISS in different age groups.ISS,NISS,ISS/LD50ISS and NISS/LD50NISS were used to predict the complications and mortality of 1,148 Chinese Han trauma patients from Daping Hospital.Receiver operating curve (ROC) analysis was performed to evaluate the predictive value.Comparison of area under the curve (AUC) was analyzed using the DeLong-DeLong non-parametric method.Results In the age groups of 16-44 years,45-64 years,and ≥65 years,LD50ISS was 55,49 and 33 respectively; LD50NISS was 62,56 and 43 respectively.To predict acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS),AUC of ISS/LD50ISSor NISS/LD50NISS was greater than that of ISS or NISS (P ＜ 0.05),indicating the predictive value of ISS/LD50ISS or NISS/LD50NISS was better than that of ISS or NISS.Whereas,these scale systems provided similar predictive value for sepsis.ISS/LD50ISS and NISS/LD50NISS demonstrated good predictive value with regard to mortality (AUC of 0.907 and 0.903 respectively).Conclusions The study works out the LD50 of ISS and NISS for Chinese Han trauma patients at different ages.ISS/LD50ISSand NISS/LD50NISS can be used as new instruments to predict ARDS,MODS and mortality in the early phase after trauma,allowing the better implementation of early intervention to improve patients' outcomes.