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The risk factors for prolonged mechanical ventilation in severe multiple injured patients with blunt chest trauma : A single center retrospective case-control study
http://hdl.handle.net/10191/50453
http://hdl.handle.net/10191/50453fa5e1463-f9a9-4fe0-a3e4-9d7ba1cb066d
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本文 (864.9 kB)
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要旨 (674.2 kB)
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| Item type | 学位論文 / Thesis or Dissertation(1) | |||||
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| 公開日 | 2019-04-15 | |||||
| タイトル | ||||||
| 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 | |||||
| タイトル | ||||||
| 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 | |||||
| 言語 | en | |||||
| 言語 | ||||||
| 言語 | eng | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | Blunt chest trauma | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | rib fracture | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | Flail chest | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | Thoracic Trauma Severity Score | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | Mechanical ventilation | |||||
| 資源タイプ | ||||||
| 資源 | http://purl.org/coar/resource_type/c_46ec | |||||
| タイプ | thesis | |||||
| その他のタイトル | ||||||
| その他のタイトル | 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 | |||||
| 著者 |
Okabe, Yasuyuki
× Okabe, Yasuyuki |
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| 著者別名 | ||||||
| 識別子Scheme | WEKO | |||||
| 識別子 | 175315 | |||||
| 姓名 | 岡部, 康之 | |||||
| 抄録 | ||||||
| 内容記述タイプ | Abstract | |||||
| 内容記述 | 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. | |||||
| 内容記述 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | 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 | |||||
| 内容記述 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | Acute Medicine & Surgery Volume 5, Issue 2 First published: 31 January 2018 | |||||
| 書誌情報 | p. 1-24, 発行日 2018-03-23 | |||||
| 出版者 | ||||||
| 出版者 | 新潟大学 | |||||
| DOI | ||||||
| 識別子タイプ | DOI | |||||
| 関連識別子 | info:doi/10.1002/ams2.331 | |||||
| 著者版フラグ | ||||||
| 値 | ETD | |||||
| 学位名 | ||||||
| 学位名 | 博士（医学） | |||||
| 学位授与機関 | ||||||
| 学位授与機関名 | 新潟大学 | |||||
| 学位授与年月日 | ||||||
| 学位授与年月日 | 2018-03-23 | |||||
| 学位授与番号 | ||||||
| 学位授与番号 | 13101甲第4409号 | |||||
| 学位記番号 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | 新大院博（医）甲第808号 | |||||
