摘要
目的 评估影响创伤患者死亡的主要危险因素。方法 检索PubMed、Web of Science、EMbase、中国生物医学文献数据库、万方、知网和维普数据库中截至2023年10月的相关文献。纳入年龄≥18岁创伤患者的队列研究或病例对照研究，排除数据无法转换成OR值及综述、个案报道、病例分析等无相关数据的文献。最终纳入17篇文献，共计5909例患者。使用纽卡斯尔-渥太华量表（NOS）对文献质量进行评价，采用STATA 17.0软件进行Meta分析。结果 Meta分析结果显示，以下因素显著增加创伤患者的死亡风险：年龄（≥60岁，OR=3.68, 95%CI: 2.28-5.24, P＜0.001）、颅脑损伤（OR=2.26, 95%CI: 1.37-3.71, P=0.001）、休克指数（>1.0，OR=5.43, 95%CI :3.54-8.34, P＜0.001）、GCS评分（≤8，OR=11.39, 95%CI: 1.96-66.37, P=0.007）、乳酸水平（OR=1.43, 95%CI: 1.26-1.61, P=0.000）、就诊时间（OR=3.58, 95%CI :2.10-6.12, P＜0.001）和ISS评分（≥16，OR=15.45, 95%CI: 9.61-24.81, P＜0.001）。机械通气与创伤患者死亡之间无显著关联（OR=1.14, 95%CI: 0.69-1.88, P=0.600）。结论 本Meta分析识别了多个显著影响创伤患者死亡的危险因素，包括年龄、颅脑损伤、休克指数、GCS评分、乳酸水平、就诊时间和ISS评分。这些结果为创伤患者的管理提供了重要参考，强调了针对高风险群体的早期干预和个性化治疗的重要性。未来研究应进一步探讨这些危险因素的具体机制，并寻求更有效的干预措施以降低创伤患者的死亡率。
关键词： 创伤和损伤；死亡率；危险因素； Meta分析
Abstract
Objective To evaluate the main risk factors affecting the death of trauma patients. Methods The related literatures up to October 2023 in PubMed, Web of Science, EMbase, China Biomedical Literature Database, Wanfang, HowNet and VIP databases were searched. CohORt study or case-control study of trauma patients aged ≥18 years were included, and literatures with no relevant data, such as reviews, case reports and case analysis, were excluded. Finally, 17 articles were included, with a total of 5909 patients. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of literature, and STATA 17.0 software was used for Meta-analysis. Results Meta-analysis showed that the following factors significantly increased the risk of death of trauma patients: Age (≥60 years old, OR = 3.68, 95% CI: 2.28-5.24, P < 0.001), craniocerebral injury (OR = 2.26, 95% CI: 1.37-3.71, P = 0.001), shock index (> 1.0, 0.001). 95%CI: 1.96-66.37, P=0.007), lactic acid level (or = 1.43, 95% ci: 1.26-1.61, p = 0.000), and time of seeing a doctor (or = 3.58, 95% ci: 2.10-6.10). There was no significant correlation between mechanical ventilation and the death of trauma patients (OR = 1.14, 95% CI: 0.69-1.88, P = 0.600). Conclusion This meta-analysis identified a number of risk factors that significantly affected the death of trauma patients, including age, craniocerebral injury, shock index, GCS score, lactic acid level, visit time and ISS score. These results provide an important reference for the management of trauma patients, and emphasize the importance of early intervention and personalized treatment for high-risk groups. Future research should further explore the specific mechanisms of these risk factors and seek more effective interventions to reduce the mortality of trauma patients.
Key words： Trauma and injury; Mortality rate; Risk factors; Meta analysis
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