Use of nonparametric method of analysis of survival for patients with closed combined abdominal trauma on the background of hypothermia

Abstract

Hypothermia is the cause of elevated levels of systemic complications and mortality in patients with combined trauma. The development of systemic complications of hypothermia involves a violation of blood coagulation, metabolic acidosis, tissue hypoperfusion, hemodynamic instability. Hypothermia, acidosis and coagulopathy considered "lethal triad" in patients with combined trauma.Methods. A multivariate analysis of 180 patients with combined closed abdominal trauma and hypothermia. In our studies it was formed the group with hypothermia victims who used the method of heating the abdominal cavity (n=53), and a group of victims with hypothermia (control group) which do not apply this method (n=127). Analysis of survival in representative groups was determined by nonparametric method of Kaplan-Meier, with a certain level of survival percentage.Results. In the study group the chance occurrence of deaths is 1.6 times less than in the controls (OR 0,62; 95% CI 0,31-1,24). Also, in the study group the risk of fatalities by 1.4 times less than in the control (RR 0,74; 95% CI 0,37-1,46).As a result, mortality in the control group affected was 40.9%, and in the study group was 30.2%, indicating a decrease in mortality in the application of complex treatment of hypothermia of 10.7%.Conclusions. It is established that hypothermia when combined with abdominal trauma is one of the factors that negatively affect the survival of patients. The use of combined treatment of hypothermia, which is complemented by the use developed device for heating the abdominal cavity, indicates a positive impact on the trauma process in victims who received closed combined abdominal trauma against the background of hypothermia