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影响芦山地震伤员住院时间的多因素分析

Multivariate Factors Analysis on Length of Stay in Lushan Earthquake Victims

  • 摘要: 目的 研究影响或预测芦山地震伤员住院时间的相关因素,为地震后一线医院床位资源的评估提供参考。方法 回顾性分析芦山地震期间四川大学华西医院收治且记录完整的263例地震伤员的临床信息。统计可能影响或可能预测伤员住院时间的10个指标〔性别、年龄、院前时间、多发伤、并发感染、合并慢性疾病、以及创伤严重度评分(ISS评分)、修正创伤评分(RTS评分)、CRAMS评分、院前伤情评分(PHI评分)〕和住院时间,进行多元逐步回归分析,筛查可能导致或预测住院时间延长的指标。结果 合并感染的地震创伤员,ISS评分越高住院时间越延长,而院前时间越长,其住院时间反而缩短。多元线性回归方程为:住院时间(h)=498.36+671.41×感染+43.87×ISS评分-5.12×院前时间。结论 地震后一线医院可根据伤员并发感染、ISS评分以及院前时间等情况,早期评估伤员病情严重程度,预测住院时间和床位资源使用情况,根据需要及时将患者转送至后方医院。

     

    Abstract: Objective To clarify the factors associate with the length of stay (LOS) in Lushan Earthquake victims. Methods We retrospectively analyzed the medical information of 263 traumatic patients admitted to West China Hospital, Sichuan University after the Lushan Earthquake. Ten variables extracted for the analysis, including gender, age, injuried time, multiple injury, infection, comorbidities, Injury Severity Score (ISS), Revised Trauma Score (RTS ) CRAMS score, and Prehospital Index (PHI ). Univariable analysis using multiple stepwise regression analysis was performed to identify the factors associated with extended LOS. Results Infection, ISS score, and Pre-hospital Time were associated with extended LOS,and infection was the most weighted factor. The regression equation is:LOS (h)=498.36+671.41×Infection +43.87×ISS score -5.12×Pre-hospital Time. Conclusion This study demonstrated that trauma patients with infections and high ISS scores were at increased risk for extended LOS and pre-hospital time decreased the risk.

     

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