Borg Jörgen, Holm Lena, Peloso Paul M, Cassidy J David, Carroll Linda J, von Holst Hans, Paniak Chris, Yates David
Department of Neuroscience, Rehabilitation Medicine, Uppsala University Hospital, Uppsala, Sweden.
J Rehabil Med. 2004 Feb(43 Suppl):76-83. doi: 10.1080/16501960410023840.
We examined the evidence for non-surgical interventions and for economic costs for mild traumatic brain injury patients by a systematic search of the literature and a best-evidence synthesis. After screening 38,806 abstracts, we critically reviewed 45 articles on intervention and accepted 16 (36%). We reviewed 16 articles on economic costs and accepted 7 (44%). We found some evidence that early educational information can reduce long-term complaints and that this early intervention need not be intensive. Most cost studies were performed more than a decade ago. Indirect costs are probably higher than direct costs. Studies comparing costs for routine hospitalized observation vs the use of computerized tomography scan examination for selective hospital admission indicate that the latter policy reduces costs, but comparable clinical outcome of these policies has not been demonstrated. The sparse scientific literature in these areas reflects both conceptual confusion and limited knowledge of the natural history of mild traumatic brain injury.
我们通过系统检索文献和最佳证据综合分析，研究了轻度创伤性脑损伤患者非手术干预措施及经济成本的相关证据。在筛选了38806篇摘要后，我们对45篇关于干预措施的文章进行了严格评审，接受了其中16篇（36%）。我们评审了16篇关于经济成本的文章，接受了其中7篇（44%）。我们发现一些证据表明，早期教育信息可减少长期不适，且这种早期干预无需过于密集。大多数成本研究是在十多年前进行的。间接成本可能高于直接成本。比较常规住院观察与使用计算机断层扫描检查进行选择性住院的成本研究表明，后一种策略可降低成本，但尚未证明这些策略具有可比的临床结果。这些领域稀疏的科学文献既反映了概念上的混乱，也反映了对轻度创伤性脑损伤自然病程的了解有限。
