Gerhart Kenneth A, Mellick David C, Weintraub Alan H
Craig Hospital, Rocky Mountain Regional Brain Injury Syste, Englewood, Colorado 80110, USA.
J Trauma. 2003 Dec;55(6):1045-53. doi: 10.1097/01.TA.0000044353.69681.96.
Most studies of traumatic brain injury (TBI) and violence are small, focus on one violent mechanism only, and are nonrepresentative. This large, population-based effort examines characteristics, circumstances of injury, treatment pathways, and outcomes of persons with TBI as a result of all types of violence, compares them with other TBI survivors, identifies a risk profile, and examines how a violent cause impacts later outcomes.
This study involved medical record abstraction and telephone survey at 1 year postinjury of a weighted sample of 2,771 Coloradans hospitalized with TBI between January 1, 1996, and June 30, 1999.
People with violently incurred TBI are more likely to be young, male, members of minority groups, single, and premorbid alcohol abusers than other TBI survivors. At 1 year postinjury, they report less community integration and more headaches, confusion, and sensory and attentional disturbances. Predictors of these outcomes included age, gender, injury severity, and employment status.
It appears that essentially the same factors that increase risk of sustaining a violent TBI negatively impact later outcomes as well.
大多数关于创伤性脑损伤（TBI）与暴力的研究规模较小，仅聚焦于一种暴力机制，且缺乏代表性。这项基于人群的大型研究考察了因各类暴力导致创伤性脑损伤患者的特征、受伤情况、治疗途径及预后，将他们与其他创伤性脑损伤幸存者进行比较，确定风险概况，并研究暴力致伤原因如何影响后期预后。
本研究涉及对1996年1月1日至1999年6月30日期间因创伤性脑损伤住院的2771名科罗拉多州患者的加权样本进行病历摘要分析和伤后1年的电话调查。
与其他创伤性脑损伤幸存者相比，因暴力导致创伤性脑损伤的患者更可能年轻、男性、属于少数群体、单身且病前有酗酒问题。伤后1年，他们报告称融入社区的程度较低，且头痛、意识模糊以及感觉和注意力障碍更多。这些预后的预测因素包括年龄、性别、损伤严重程度和就业状况。
似乎增加暴力性创伤性脑损伤风险的基本相同因素也会对后期预后产生负面影响。
