소아 외상 환자에서 나이 보정 쇼크지수와 사망의 연관: 한국 단일기관 연구
Association of age-adjusted shock index with mortality in children with trauma: a single-center study in Korea
윤은비, 허요, 고유라, 김중헌,
소속 상세정보
윤은비 ( Yoon Eun-Bi )
Ajou University College of Medicine Department of Emergency Medicine
허요 ( Huh Yo )
Ajou University School of Medicine Department of Surgery
고유라 ( Ko Yu-Ra )
Ajou University College of Medicine Department of Emergency Medicine
김중헌 ( Kim Jung-Heon )
Ajou University College of Medicine Department of Emergency Medicine
Abstract
Purpose: This study was performed to investigate the association of high age-adjusted shock index (AASI) with mortality in Korean children with trauma.
Methods: The data of children (aged < 15 years) with trauma who visited an university hospital in Korea from 2010 through 2018 were reviewed. High AASI was defined by age groups as follows: < 12 months, ≥ 2.7; 12-23 months, ≥ 2.1; 2-4 years, ≥ 1.9; 5-11 years, ≥ 1.5; and 12-14 years, ≥ 1.1. Age, sex, transfer status, injury mechanism, hypotension, tachycardia, base deficit, hemoglobin concentration, trauma scores, hemorrhage-related procedures (transfusion and surgical interventions), and severe traumatic brain injury were compared according to high AASI and in-hospital mortality. The association of high AASI with the mortality was analyzed using logistic regression.
Results: Of the 363 enrolled children, 29 (8.0%) had high AASI and 24 (6.6%) died. The children with high AASI showed worse trauma scores and underwent hemorrhage-related procedures more frequently, without a difference in the rate of the traumatic brain injury. High AASI was associated with in-hospital mortality (survivors, 6.5% vs. non-survivors, 29.2%; P = 0.001). This association remained significant after adjustment (adjusted odds ratio, 6.42; 95% confidence interval, 1.38-29.82). The other predictors were Glasgow Coma Scale (for increment of 1 point; 0.62; 0.53-0.72) and age (for increment of 1 year; 0.84; 0.73-0.97). High AASI showed a 29.2% sensitivity and 93.5% specificity for the mortality.
Conclusion: High AASI is associated with mortality, and have a high specificity but low sensitivity in Korean children with trauma. This predictor of mortality can be used prior to obtaining the results of laboratory markers of shock.
키워드
Accidental Injuries; Age Groups; Child; Mortality; Multiple Trauma; Shock
원문 및 링크아웃 정보
등재저널 정보