Objective To compare the predictive values of base excess (BE), lactate and pH of admission arterial blood gas for 72-h mortality in patients with multiple trauma. Methods This was a secondary analysis based on a publicly shared trauma dataset from the Dryad database, which provided the clinical data of 3669 multiple trauma patients with ISS > = 16. The records of BE, lactate, pH and 72-h prognosis data without missing values were selected from this dataset and 2441 individuals were enrolled in the study. Logistic regression model was performed to calculate the odds ratios (ORs) of variables. Area under the curve (AUC) of receiver operating curve (ROC) was utilized to evaluate the predictive value of predictors for 72 h in-hospital mortality. Pairwise comparison of AUCs was performed using the Delong’s test. Results The statistically significant correlations were observed between BE and lactate (r = − 0.5861, p < 0.05), lactate and pH (r = − 0.5039, p < 0.05), and BE and pH (r = − 0.7433, p < 0.05). The adjusted ORs of BE, lactate and pH for 72-h mortality with the adjustment for factors including gender, age, ISS category were 0.872 (95%CI: 0.854–0.890), 1.353 (95%CI: 1.296–1.413) and 0.007 (95%CI: 0.003–0.016), respectively. The AUCs of BE, lactate and pH were 0.693 (95%CI: 0.675–0.712), 0.715 (95%CI: 0.697–0.733), 0.670 (95%CI: 0.651–0.689), respectively. Conclusions There are significant correlations between BE, lactate and pH of the admission blood gas, all of them are independent predictors of 72-h mortality for multiple trauma. Lactate may have the best predictive value, followed by BE, and finally pH.

Objective To test the following hypothesis: the ratio of shock index to pulse oxygen saturation can better predict the mortality of emergency trauma patients than shock index. Methods 1723 Patients of trauma admitted to the Emergency Department of the First Affiliated Hospital of Soochow University from 1 November 2016 to 30 November 2019 were retrospectively evaluated. We defined SS as the ratio of SI to SPO2, and the mortality of trauma patients in the emergency department as end-point of outcome. We calculated the crude HR of SS and adjusted HR with the adjustment for risk factors including sex, age, revised trauma score (RTS) by Cox regression model. ROC curve analyses were performed to compare the area under the curve (AUC) of SS and SI. Results The crude HR of SS was: 4.31, 95%CI (2.89-6.42) and adjusted HR: 3.01, 95%CI(1.86-4.88); ROC curve analyses showed that AUC of SS was higher than that of shock index (SI), and the difference was statistically significant: 0.69, 95%CI(0.55-0.83) vs 0.65, 95%CI (0.51-0.79), P = 0.001. Conclusion The ratio of shock index to pulse oxygen saturation is good predictor for emergency trauma patients, which has a better prognostic value than shock index.

Abstract Objective To analyze and summarize the epidemiological characteristics of patients with alcohol-related trauma through a large dataset. Methods The medical records of 46338 patients with pre-hospital trauma in 2019 were exported from Suzhou pre-hospital first aid information system. The medical history was matched by regular expression, and the trauma cases including "drinking", "drunk driving" and "alcoholism" were defined as alcohol-related trauma (ART). Statistical analysis was performed from the respects of age distribution, sex composition, injury mechanism, onset time and injury condition. Results 1997 patients with alcohol-related trauma were screened, including 1791 males, accounting for 89.68%. The age in the male group was older than that in the female group [median (IQR)]: 39 (16) vs. 31 (15), p < 0.001. The top three injury mechanisms were fall down (32%), violence (28.49%) and traffic accidents (24.89%). In terms of time distribution, alcohol-related injuries mostly occurred at from 20:00 to 00:00 and Friday, Saturday and Sunday. The shock risk of violent was significantly higher than that of other types of trauma. Taking traffic accidents as a reference baseline, we calculated the crude OR and the adjusted OR with the adjustment for sex and age, which were 2.57, 95%(1.54–4.30), p < 0.001; 2.39, 95%CI(1.42–4.01), p = 0.001, repspectively. Conclusion ART mainly occurs in male population and the average age of male is higher than that of female, and it is more common in falls, violence and traffic accidents, especially from 20:00 to 00:00 at night and on weekends. Violence can more easily lead to shock than other types of trauma, which suggests more serious injury and worse outcome.

Background: The aim of the study is to evaluate the extent to which patients acquired necessary knowledge about pancreatic endoscopic ultrasound-guided fine needle aspiration and assess what should be more focused on in the informed consent process. Methods: Adult patients enrolled in this study had pancreatic lesions confirmed by regular imaging and planned to undergo the first pancreatic endoscopic ultrasound-guided fine needle aspiration. These patients were asked to complete a questionnaire, including indications, possible results, downstream events, the risk for false-negative and malignant lesions, and so on. Then we conducted a long-term follow-up of these patients to obtain the final results. Results: Most people (94.25%) correctly recognized that the indication of pancreatic endoscopic ultrasound-guided fine needle aspiration was to exclude malignant lesions. Almost all patients knew that the results could be benign or malignant, while the number of people who were aware of non-diagnostic (22%), indeterminate (18%) outcomes, and the possibility of further testing (20%) after the endoscopic ultrasound-guided fine needle aspiration has decreased significantly. Finally, we got that the false-negative rate and percentages of malignancy were 17.81% and 83.91%, while 98% of participants did not recognize that there is a false-negative risk of endoscopic ultrasound-guided fine needle aspiration and more than 2/3 of participants did not know how much risk they might have for malignant lesions. Conclusions: A high proportion of patients who received endoscopic ultrasound-guided fine needle aspiration could identify the indication for this procedure but remained unaware of possible outcomes, downstream events, especially the risk for false-negative and malignant lesions. It is necessary to improve the quality of dialogue between clinicians and patients, and the information about the risk of false-negative and malignancy may need to be emphasized in the informed consent process.

Abstract Objective To analyze and summarize the epidemiological characteristics of patients with alcohol-related trauma through a large dataset. Methods The medical records of 46338 patients with pre-hospital trauma in 2019 were exported from Suzhou pre-hospital first aid information system. The medical history was matched by regular expression, and the trauma cases including "drinking", "drunk driving" and "alcoholism" were defined as alcohol-related trauma (ART). Statistical analysis was performed from the respects of age distribution, sex composition, injury mechanism, onset time and injury condition. Results 1997 patients with alcohol-related trauma were screened, including 1791 males, accounting for 89.68%. The age in the male group was older than that in the female group [median (IQR)]: 39 (16) vs. 31 (15), p < 0.001. The top three injury mechanisms were fall down (32%), violence (28.49%) and traffic accidents (24.89%). In terms of time distribution, alcohol-related injuries mostly occurred at from 20:00 to 00:00 and Friday, Saturday and Sunday. The shock risk of violent was significantly higher than that of other types of trauma. Taking traffic accidents as a reference baseline, we calculated the crude OR and the adjusted OR with the adjustment for sex and age, which were 2.57, 95%(1.54–4.30), p < 0.001; 2.39, 95%CI(1.42–4.01), p = 0.001, repspectively. Conclusion ART mainly occurs in male population and the average age of male is higher than that of female, and it is more common in falls, violence and traffic accidents, especially from 20:00 to 00:00 at night and on weekends. Violence can more easily lead to shock than other types of trauma, which suggests more serious injury and worse outcome.