Harris Colin, DiRusso Stephen, Sullivan Tom, Benzil Deborah L
Department of Neurosurgery, New York Medical College, Valhalla, NY, USA.
J Am Coll Surg. 2003 Nov;197(5):711-6. doi: 10.1016/S1072-7515(03)00729-4.
Age has long been recognized as a critical factor in predicting outcomes after head injury, with individuals older than 60 years predicted to have a worse outcome than those younger than 60. The object of this study was to determine the effect of age by decade of life beginning at birth in patients with head injuries of all levels of severity.
The New York State Trauma Registry was searched for head injuries from January 1, 1994 to December 31, 1995; the 13,908 cases found were placed into age groups by decade. Data were sought for each patient on demographics, Glasgow Coma Score, ICD-9 injury code, New Injury Severity Score (NISS), and mechanism of injury. These data were analyzed with chi-square and one-way ANOVA tests, with significance set at p < 0.05.
The risk of dying was significantly increased in patients beginning at 30 years of age compared with those in the younger age groups, with the greatest increases occurring after age 60 (p < 0.001). For the population with available Glasgow Coma Score data (n = 12,844), the mortality rate for patients ages 0 to 30 was 10.9%, and for patients ages 31 to 50 was 12.4%. The mean Glasgow Coma Score for nonsurvivors ages 0 to 20 (3.9) and for nonsurvivors ages 31 to 50 (5.1) were significantly different, with a risk ratio of 1.3 (p < 0.001).
The risk of dying for patients suffering head injuries increases as early as 30 years of age, making it necessary for health-care providers to consider increased monitoring and treatment for patients in this younger age group.
长期以来，年龄一直被认为是预测头部受伤后预后的关键因素，预计60岁以上的个体比60岁以下的个体预后更差。本研究的目的是确定从出生开始按十年划分的年龄对所有严重程度头部损伤患者的影响。
检索纽约州创伤登记处1994年1月1日至1995年12月31日期间的头部损伤病例；将找到的13908例病例按十年划分为年龄组。收集每位患者的人口统计学、格拉斯哥昏迷评分、ICD-9损伤代码、新损伤严重程度评分（NISS）和损伤机制等数据。这些数据采用卡方检验和单因素方差分析进行分析，显著性设定为p<0.05。
与较年轻年龄组相比，30岁开始的患者死亡风险显著增加，60岁以后增加最为明显（p<0.001）。对于有可用格拉斯哥昏迷评分数据的人群（n = 12844），0至30岁患者的死亡率为10.9%，31至50岁患者的死亡率为12.4%。0至20岁非幸存者的平均格拉斯哥昏迷评分为3.9，31至50岁非幸存者的平均格拉斯哥昏迷评分为5.1，两者有显著差异，风险比为1.3（p<0.001）。
头部受伤患者的死亡风险早在30岁时就开始增加，这使得医疗保健提供者有必要考虑加强对这一年轻年龄组患者的监测和治疗。
