@misc{oai:niigata-u.repo.nii.ac.jp:00006007, author = {Okabe, Yasuyuki}, month = {Mar}, note = {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}, title = {The risk factors for prolonged mechanical ventilation in severe multiple injured patients with blunt chest trauma : A single center retrospective case-control study}, year = {2018} }