【摘要】 目的探究汶川地震伤员早期伤情评估指标与其在一线医院住院时间的相关性,为地震等灾难发生时,能更高效利用一线医院的医疗资源、合理分流伤员提供理论依据和借鉴。方法回顾性收集2008年5月12日14:28-19日14:30汶川地震期间,3 576例转运至242家一线医疗机构的北川地震伤员的临床信息。基于文献查阅,筛选出可能与伤员住院时间有关、并且可在入院时能快速获取的3类15项指标:一般情况(性别、年龄、是否有心肺基础疾病)、受伤情况(受伤至接受救治的间隔时间、是否头部损伤、是否躯干损伤、是否开放伤、是否挤压伤、院前是否窒息)、入院时基本情况(体温、呼吸、心率、收缩压、舒张压、格拉斯哥昏迷评分。将上述指标与住院时间进行多重逐步线性回归分析,得出可能与其住院时间相关的指标。结果在回归分析中,进入回归方程的指标包括年龄(偏回归系数=-0.062,P=0.033)、受伤到救治间隔时间(偏回归系数=0.157,P<0.001)、头部损伤(偏回归系数=3.703,P=0.002)、躯干损伤(偏回归系数=4.111,P=0.002)、挤压伤(偏回归系数=12.602,P<0.001)、心肺基础疾病史(偏回归系数=14.762,P<0.001)和格拉斯哥昏迷评分(偏回归系数=-1.312,P=0.035)。结论地震后一线医院医生可根据伤员的年龄、受伤到接收救治的间隔时间、头部损伤、躯干损伤、挤压伤、格拉斯哥昏迷评分和心肺基础疾病等情况,早期预估伤员的住院时间,合理分流其至后方医院,以保障一线医院住院床位资源供应。更多还原

【Abstract】 Objective To explore the possible association between early injury assessment indexes and the length of stay(LOS) in first-line hospitals, in order to help the hospitals take advantage of resource effectively and transfer victims reasonably during earthquakes. Methods We retrospectively analyzed the medical information of 3 576 traumatic patients injured in the Wenchuan Earthquake who were transferred to 242 first-line medical institutes between 14:28, May 12 th and 14:30, May 19 th in 2008. Three kinds of 15 variables were extracted for the analysis, including gender, age, heart or lung disease, pre-hospital time, head injury, trunk injury, open injury, crush injury, asphyxia, body temperature, heart rate, respiration, systolic blood pressure, diastolic blood pressure, and Glasgow coma score. Multiple stepwise linear regression analysis was performed to identify the factors associated with LOS. Results The multiple linear regression analysis showed that age as well as other six factors affected LOS significantly(P < 0.05). The partial regression coefficients of age, pre-hospital time, head injury, trunk injury, crush injury, complication of cardiac or pulmonary disease, and Glasgow coma score were-0.062, 0.157, 3.703, 4.111, 12.602, 14.762 and-1.312, respectively. Conclusion Earthquake trauma patients with older age, long pre-hospital time, head injury, trunk injury, heart or lung disease, crush injury, and lower Glasgow coma score are at increased risk for extended LOS.更多还原