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대장 및 직장 손상의 예후 분석

Analysis of the Risk Factors in Colorectal Injuries

대한대장항문학회지 2000년 16권 6호 p.423 ~ 428
여준희 ( Yeo Jun-Hee ) - 전북대학교 의과대학 외과학교실

전관희 ( Jun Gwan-Hee ) - 전북대학교 의과대학 외과학교실
이태훈 ( Lee Tae-Hoon ) - 전북대학교 의과대학 외과학교실
김종훈 ( Kim Jong-Hun ) - 전북대학교 의과대학 외과학교실

Abstract


Purpose: To evaluate factors that influence morbidity and mortality in colorectal injuries.

Methods: We reviewed the medical records of 59 patients who underwent emergency operation in JNUH from Jan. 1988 through Dec. 1997. Univariate and multivariate analyses were used to calculate the prognostic significance of the following variables: sex, age, time to operation, preoperative shock, penetrating abdominal trauma index (PATI), APACHE II score, site of injury, organ injury scale (OIS), Flint grade, associated intraabdominal injuries, the sum of transfusion during 48hours of preoperative and postoperative period and operative method.

Results: Univariate analysis showed that colorectal organ iujury scale, and operative method were related to the complication, and preoperative shock, APACHE II score, PATI, and transfusion in 48hrs of injury were related to the mortality of colorectal injury. Multivariate logistic regression analysis showed that colorectal organ injury scale (2 vs 1) was significant risk factor in the development of complication, and the odds ratios were 5.0 and 1.69 respectively. The sum of transfusion in 48hours of injury was a only significant risk factor in the mortality and the odds ratio was 1.5.

Conclusion: We concluded that preoperative condition was very important and preservation of hemodynamic stability was critical in improvement of prognosis. We also concluded that the shortening of operative time and proper management of associated injury may reduce the development of complication and even death.

키워드

대장직장손상;위험인자
Colorectal injury;Risk factor
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