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男性和女性在创伤性脑损伤后的病程是否存在差异?一项关于早期预后的初步前瞻性调查。

Do men and women differ in their course following traumatic brain injury? A preliminary prospective investigation of early outcome.

作者信息

Slewa-Younan Shameran, Baguley Ian J, Heriseanu Roxana, Cameron Ian D, Pitsiavas Vicki, Mudaliar Yugan, Nayyar Vineet

机构信息

Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, NSW, Australia.

出版信息

Brain Inj. 2008 Feb;22(2):183-91. doi: 10.1080/02699050801888808.

Abstract

PRIMARY OBJECTIVE

To examine the effect of a patient's sex on measures of outcome in a matched sample of patients admitted for acute traumatic brain injury (TBI).

RESEARCH DESIGN

A prospective multi-centred group comparison study based in metropolitan Sydney, Australia.

METHODS AND PROCEDURES

Data was collected on 25 women admitted for treatment following non-penetrating TBI. Forty-five men were then matched with regards to age and injury severity. All subjects met the study criteria of having a moderate-to-severe TBI and aged 50 years old or younger. Exclusion criteria included history of previous head injury, psychiatric disturbance and significant alcohol and/or substance abuse. Data included injury details and physiological and psychometric measures of outcome.

MAIN OUTCOMES AND RESULTS

Women demonstrated better outcomes as indicated by their Glasgow Outcome Scale scores (adjusted for initial injury severity and age at injury odds ratio [OR] 4.2, 95% CI 1.4-12.7) and having shorter Length of Stay (adjusted OR 9.03, 95% CI 3.13-26.08).

CONCLUSIONS

Understanding the presence of sex differences in outcome following TBI is an emerging area of research. This study indicated that, after matching for initial injury severity and age at injury, women with severe TBI demonstrate a better early outcome than men.

摘要

主要目的

在因急性创伤性脑损伤(TBI)入院的患者匹配样本中,研究患者性别对预后指标的影响。

研究设计

一项基于澳大利亚悉尼大都市的前瞻性多中心组间比较研究。

方法与步骤

收集了25名因非穿透性TBI入院治疗的女性患者的数据。然后根据年龄和损伤严重程度匹配了45名男性患者。所有受试者均符合中度至重度TBI且年龄在50岁及以下的研究标准。排除标准包括既往头部受伤史、精神障碍以及大量饮酒和/或药物滥用史。数据包括损伤细节以及预后的生理和心理测量指标。

主要结局与结果

格拉斯哥预后量表评分(根据初始损伤严重程度和受伤时年龄调整,优势比[OR]为4.2,95%置信区间为1.4 - 12.7)表明女性预后更好,且住院时间更短(调整后的OR为9.03,95%置信区间为3.13 - 26.08)。

结论

了解TBI后预后存在的性别差异是一个新兴的研究领域。本研究表明,在根据初始损伤严重程度和受伤时年龄进行匹配后,重度TBI女性的早期预后优于男性。

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