ISS评分对严重创伤患者病情及预后的预测价值

摘要

Objective To identify the value of ISS score in evaluating disease condition and prognosis of se-vere trauma.Methods A total of 560 patients with severe trauma admitted in Department of Emergency Medicine,Han-zhong Central Hospital from Feb.2016 to Feb.2017 were divided into group A(16≤ISS score<50,384 cases)and group B(ISS score≥50,176 cases)according to ISS score.The differences between the two groups were analyzed in trauma site,the cause of trauma,the condition before admission,the total time of hospitalization and the treatment effect.Accord-ing to the distribution of trauma site of patients, the difference between ISS score and mortality rate was compared be-tween different parts. Results The incidences of chest, limbs, pelvis, abdominal and pelvic injury in group B were 50.0%,54.0%,35.2% and 58.5% respectively,versus 32.0%,45.1%,15.9% and 42.7% in group A(P<0.05).The inci-dence of anxiety,disturbance were 21.0%,54.5% in group B versus 4.9%,18.5% in group A(P<0.05).The average hospi-tal stay,hospital mortality were 84 d,38.1% in group B versus 47 d,10.7% in group A(P<0.05). Conclusion Higher ISS score is associated with more serious the disease condition and higher mortality,which can serve as a reference in-dex for evaluating the disease condition and prognosis of severe trauma.%目的 分析ISS评分对严重创伤患者病情及预后的预测价值.方法 选取2016年2月至2017年2月汉中市中心医院急诊科收治的严重创伤患者560例,按照ISS评分情况分为A组[16分≤损伤严重程度评分(ISS)评分<50分]、B组(ISS评分≥50分),其中A组384例,B组176例,分析比较两组患者在创伤部位、创伤原因、入院前情况、住院总时间、治疗效果等方面的差异,并比较各部位之间ISS评分与死亡率的差异.结果 B组患者中胸部、四肢及骨盆、腹部及盆腔损伤发生率及因交通事故致伤概率分别为50.0%、54.0%、35.2%、58.5%,A组分别为32.0%、45.1%、15.9%、42.7%,B组显著高于A组,差异有统计学意义(P<0.05);B组患者入院前休克发生率(21.0%)、意识障碍发生率(54.5%)显著高于A组(4.9%、18.5%),差异有统计学意义(P<0.05);B组患者平均住院时间(84 d)、院内死亡率(38.1%)均高于A组(47 d、10.7%),差异均有统计学意义(P<0.05).结论 ISS评分越高,病情越严重,死亡率越高,ISS评分可初步作为预测严重创伤患者病情及预后情况的参考指标.