The risk factors for prolonged mechanical ventilation in severe multiple injured patients with blunt chest trauma : A single center retrospective case-control study

• 資料種別: 博士論文
• タイトル: The risk factors for prolonged mechanical ventilation in severe multiple injured patients with blunt chest trauma : A single center retrospective case-control study
• 著者・編者: Okabe, Yasuyuki
• 出版事項: 新潟大学
• 出版年月日等: 2018-03-23
• 出版年（W3CDTF）: 2018-03-23
• 並列タイトル等: The risk factors for prolonged mechanical ventilation in severe multiple injured patients with blunt chest trauma : A single center retrospective case-control study; 鈍的胸部外傷を有する重症多発外傷患者における人工呼吸器長期化のリスク因子の検討 :単施設後方視的症例対象研究
• 授与機関名: 新潟大学
• 授与年月日: 2018-03-23
• 授与年月日（W3CDTF）: 2018-03-23
• 報告番号: 甲第4409号
• 学位: 博士（医学）
• 博論授与番号: 甲第4409号
• 本文の言語コード: eng
• 件名標目: Blunt chest trauma; rib fracture; Flail chest; Thoracic Trauma Severity Score; Mechanical ventilation
• 一般注記: Aim: Blunt chest trauma is common and associated with morbidity and mortality in multiple injured patients, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (PMV). Methods: Consecutive adult multiple severe injured patients with blunt chest trauma treated in Chiba emergency medical center (Chiba city, Japan) between January 2008 and December 2015 were enrolled in this retrospective chart-review study. According to ventilatory time, the patients were divided into PMV (≥7 days) and shortened mechanical ventilation (SMV; <7 days) groups. Thoracic Trauma Severity Score (TTSS) was calculated. To identify risk factors for PMV, univariate and multivariate logistic analyses, and receiver operating characteristic analysis (ROC) were performed. Results: 84 and 49 patients were assigned to PMV and SMV groups, respectively. Compared with SMV group, PMV group had a significantly larger number of fractured ribs (p<0.01), higher rate of severe Glasgow Coma Scale (GCS≤8) (p<0.05) and flail chest (p<0.001), higher TTSS (p<0.001), or longer ICU and hospital stay (both p<0.001). Logistic analysis showed that severe GCS (OR=4.6, p<0.01), flail chest (OR=3.0, p<0.05), or TTSS (OR=1.2; p<0.01) was an independent significant risk factor. ROC showed that area under curve (AUC) for TTSS, flail chest, and severe GCS was 0.74, 0.70, and 0.58, respectively. When the 3 factors were combined, AUC increased to 0.8. Conclusion: Severe GCS (≤8), flail chest, or TTSS may be independent risk factors. Combining the 3 risk factors may provide high predictive performance for PMV.; 学位の種類: 博士（医学）. 報告番号: 甲第4409号. 学位記番号: 新大院博（医）甲第808号. 学位授与年月日: 平成30年3月23日; Acute Medicine & Surgery Volume 5, Issue 2 First published: 31 January 2018; 新大院博（医）甲第808号; 開始ページ : 1; 終了ページ : 24
• DOI: info:doi/10.1002/ams2.331; https://doi.org/info:doi/10.1002/ams2.331
• 国立国会図書館永続的識別子: info:ndljp/pid/11278363; https://dl.ndl.go.jp/pid/11278363
• コレクション（共通）: 障害者向け資料
• コレクション（障害者向け資料：レベル1）: テキストデータ
• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 受理日（W3CDTF）: 2019-05-06T10:27:56+09:00
• 作成日（W3CDTF）: 2019-08-05
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: 国立国会図書館内限定公開
• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 掲載誌（URI）: http://hdl.handle.net/10191/50453
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp