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Characteristics and Risk Factors of Myocardial Injury after Traumatic Hemorrhagic Shock
Myocardial injury increases major adverse cardiovascular events and mortality in patients with traumatic hemorrhagic shock, but its prevalence and risk factors remain unclear. This study aimed to assess the prevalence and risk factors of myocardial injury after traumatic hemorrhagic shock. This was...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409653/ https://www.ncbi.nlm.nih.gov/pubmed/36013038 http://dx.doi.org/10.3390/jcm11164799 |
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author | Zhao, Xiujuan Guo, Fuzheng Wang, Chu Wang, Zhenzhou Chang, Panpan Xue, Haiyan Wang, Tianbing Zhu, Fengxue |
author_facet | Zhao, Xiujuan Guo, Fuzheng Wang, Chu Wang, Zhenzhou Chang, Panpan Xue, Haiyan Wang, Tianbing Zhu, Fengxue |
author_sort | Zhao, Xiujuan |
collection | PubMed |
description | Myocardial injury increases major adverse cardiovascular events and mortality in patients with traumatic hemorrhagic shock, but its prevalence and risk factors remain unclear. This study aimed to assess the prevalence and risk factors of myocardial injury after traumatic hemorrhagic shock. This was an observational, retrospective cohort study of patients with traumatic hemorrhagic shock at a tertiary university hospital from November 2012 to July 2021. Patient characteristics and clinical variables were recorded in 314 patients. The outcome was the occurrence of myocardial injury after traumatic hemorrhagic shock. Risk factors for myocardial injury were identified using logistic regression. The incidence of myocardial injury after the traumatic hemorrhagic shock was 42.4%, and 95.5% of myocardial injuries occurred within the first three days after trauma. In the multivariate analysis, the independent risk factors for myocardial injury after traumatic hemorrhagic shock included heart rate of >100 beats/min (OR [odds ratio], 3.33; 95% confidence interval [CI], 1.56–7.09; p = 0.002), hemoglobin level of <70 g/L (OR, 3.50; 95% CI, 1.15–10.60; p = 0.027), prothrombin time of >15 s (OR, 2.39; 95% CI, 1.12–5.10; p = 0.024), acute kidney injury (OR, 2.75; 95% CI, 1.27–5.93; p = 0.01), and a higher APACHE II score (OR, 1.08; 95% CI, 1.01–1.15; p = 0.018). The area under the receiver operating characteristic curve for the prediction of myocardial injury after a traumatic hemorrhagic shock was 0.67 (95% CI, 0.68–0.79) for a heart rate of >100 beats/min, 0.67 (95% CI, 0.61–0.73) for hemoglobin level of <70 g/L, 0.66 (95% CI, 0.60–0.73) for prothrombin time of >15 s, 0.70 (95% CI, 0.64–0.76) for acute kidney injury, and 0.78 (95% CI, 0.73–0.83) for APACHE II scores. The incidence rate of myocardial injury in traumatic hemorrhagic shock is high, and heart rates of >100 beats/min, hemoglobin levels of <70 g/L, prothrombin times of >15 s, AKI and higher APACHE II scores are independent risk factors for myocardial injury after traumatic hemorrhagic shock. These findings may help clinicians to identify myocardial injury after traumatic hemorrhagic shock early and initiate appropriate treatment. |
format | Online Article Text |
id | pubmed-9409653 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94096532022-08-26 Characteristics and Risk Factors of Myocardial Injury after Traumatic Hemorrhagic Shock Zhao, Xiujuan Guo, Fuzheng Wang, Chu Wang, Zhenzhou Chang, Panpan Xue, Haiyan Wang, Tianbing Zhu, Fengxue J Clin Med Article Myocardial injury increases major adverse cardiovascular events and mortality in patients with traumatic hemorrhagic shock, but its prevalence and risk factors remain unclear. This study aimed to assess the prevalence and risk factors of myocardial injury after traumatic hemorrhagic shock. This was an observational, retrospective cohort study of patients with traumatic hemorrhagic shock at a tertiary university hospital from November 2012 to July 2021. Patient characteristics and clinical variables were recorded in 314 patients. The outcome was the occurrence of myocardial injury after traumatic hemorrhagic shock. Risk factors for myocardial injury were identified using logistic regression. The incidence of myocardial injury after the traumatic hemorrhagic shock was 42.4%, and 95.5% of myocardial injuries occurred within the first three days after trauma. In the multivariate analysis, the independent risk factors for myocardial injury after traumatic hemorrhagic shock included heart rate of >100 beats/min (OR [odds ratio], 3.33; 95% confidence interval [CI], 1.56–7.09; p = 0.002), hemoglobin level of <70 g/L (OR, 3.50; 95% CI, 1.15–10.60; p = 0.027), prothrombin time of >15 s (OR, 2.39; 95% CI, 1.12–5.10; p = 0.024), acute kidney injury (OR, 2.75; 95% CI, 1.27–5.93; p = 0.01), and a higher APACHE II score (OR, 1.08; 95% CI, 1.01–1.15; p = 0.018). The area under the receiver operating characteristic curve for the prediction of myocardial injury after a traumatic hemorrhagic shock was 0.67 (95% CI, 0.68–0.79) for a heart rate of >100 beats/min, 0.67 (95% CI, 0.61–0.73) for hemoglobin level of <70 g/L, 0.66 (95% CI, 0.60–0.73) for prothrombin time of >15 s, 0.70 (95% CI, 0.64–0.76) for acute kidney injury, and 0.78 (95% CI, 0.73–0.83) for APACHE II scores. The incidence rate of myocardial injury in traumatic hemorrhagic shock is high, and heart rates of >100 beats/min, hemoglobin levels of <70 g/L, prothrombin times of >15 s, AKI and higher APACHE II scores are independent risk factors for myocardial injury after traumatic hemorrhagic shock. These findings may help clinicians to identify myocardial injury after traumatic hemorrhagic shock early and initiate appropriate treatment. MDPI 2022-08-17 /pmc/articles/PMC9409653/ /pubmed/36013038 http://dx.doi.org/10.3390/jcm11164799 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Zhao, Xiujuan Guo, Fuzheng Wang, Chu Wang, Zhenzhou Chang, Panpan Xue, Haiyan Wang, Tianbing Zhu, Fengxue Characteristics and Risk Factors of Myocardial Injury after Traumatic Hemorrhagic Shock |
title | Characteristics and Risk Factors of Myocardial Injury after Traumatic Hemorrhagic Shock |
title_full | Characteristics and Risk Factors of Myocardial Injury after Traumatic Hemorrhagic Shock |
title_fullStr | Characteristics and Risk Factors of Myocardial Injury after Traumatic Hemorrhagic Shock |
title_full_unstemmed | Characteristics and Risk Factors of Myocardial Injury after Traumatic Hemorrhagic Shock |
title_short | Characteristics and Risk Factors of Myocardial Injury after Traumatic Hemorrhagic Shock |
title_sort | characteristics and risk factors of myocardial injury after traumatic hemorrhagic shock |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409653/ https://www.ncbi.nlm.nih.gov/pubmed/36013038 http://dx.doi.org/10.3390/jcm11164799 |
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