[Risk factors affecting the survival rate in serious multiple trauma patients associated with acute lung injure/acute respiratory distress syndrome].

ABSTRACT

OBJECTIVE: To investigate risk factors affecting the survival rate in serious multiple traumatic patients associated with acute lung injure (ALI)/acute respiratory distress syndrome (ARDS). METHODS: The clinical data of 76 serious multiple trauma patients associated with ALI and 95 cases in ARDS, totally 171 patients associated with ALI/ARDS, were retrospectively studied, and stepwise logistic regression analysis was used to analyze 20 possible risk factors affecting survival rate. RESULTS: The risk factors affecting survival rate in the ALI group included smoking (B = -5.235, OR = 0.005, P = 0.001), sepsis secondary to trauma (B = -2.753, OR = 0.064, P = 0.031), and gastrointestinal hemorrhage (B = -2.876, OR = 0.056, P = 0.033). The risk factors affecting survival rate in the ARDS group included the time of induction factor persisting to attacking (B = 3.524, OR = 33.933, P = 0.008), sepsis secondary to trauma (B = -5.183, OR = 0.006, P = 0.004); renal insufficiency(B = -4.745, OR = 0.009, P = 0.009), and gastrointestinal hemorrhage (B = -6.335, OR = 0.002, P = 0.007). CONCLUSION: Different from the results of study of traditional risk factors affecting survival rate in ALI/ARDS, this study reveals that smoking may be an independent risk factor; the earlier ALI/ARDS appears, the lower the predictable survival rate in condition of serious multiple trauma; MODS is easily induced in the course of complicating renal insufficiency during the time of lung injury; sepsis and gastrointestinal hemorrhage are still the infective factors or infection inducing factors affecting the survival rate after trauma; and the primary disease causing infection must be treated actively.