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急诊科钝性颅脑损伤患者死亡率的预测因素。

Factors predicting mortality in victims of blunt trauma brain injury in emergency department settings.

作者信息

Hsiao K-Y, Hsiao C-T, Weng H-H, Chen K-H, Lin L-J, Huang Y-M

机构信息

Department of Emergency Medicine, Chiayi Chang Gung Memorial Hospital, No 6, West Section, Chia-Pu Road, Puzih City, Chiayi County 613, Taiwan, ROC.

出版信息

Emerg Med J. 2008 Oct;25(10):670-3. doi: 10.1136/emj.2007.053405.

Abstract

OBJECTIVE

The aim of the study was to identify risk factors for mortality in patients brought to the emergency department (ED) after blunt traumatic brain injury (TBI).

METHODS

The medical records of such patients who visited the ED from June 2004 to May 2005 were retrospectively reviewed. Data (age, gender, initial Glasgow coma scale (GCS) scores, initial vital signs, brain computed tomography scan findings and cause of trauma) were collected from the records of 204 TBI patients, who were treated at the ED and needed intensive care. Among these patients, 48 died in the intensive care unit (ICU) of the hospital. Logistic regression was used to assess factors affecting mortality after trauma.

RESULTS

Age (odds ratio (OR) 1.04; 95% CI 1.01 to approximately 1.07), GCS score less than 9 (OR 19.29; 95% CI 5.04 to approximately 73.82) and skull bone fracture (OR 10.44; 95% CI 3.59 to approximately 30.38) were identified as possible risk factors of mortality in TBI patients.

CONCLUSION

These predictors appear to be clinically relevant and may help improve ED triage of TBI patients in need of ICU care.

摘要

目的

本研究旨在确定钝性颅脑损伤(TBI)后被送至急诊科(ED)的患者的死亡风险因素。

方法

回顾性分析2004年6月至2005年5月期间就诊于急诊科的此类患者的病历。从204例在急诊科接受治疗且需要重症监护的TBI患者的记录中收集数据(年龄、性别、初始格拉斯哥昏迷量表(GCS)评分、初始生命体征、脑部计算机断层扫描结果和创伤原因)。在这些患者中,48例在医院重症监护病房(ICU)死亡。采用逻辑回归分析评估创伤后影响死亡率的因素。

结果

年龄(比值比(OR)1.04;95%置信区间1.01至约1.07)、GCS评分低于9分(OR 19.29;95%置信区间5.04至约73.82)和颅骨骨折(OR 10.44;95%置信区间3.59至约30.38)被确定为TBI患者可能的死亡风险因素。

结论

这些预测指标似乎具有临床相关性,可能有助于改善对需要ICU护理的TBI患者的急诊科分诊。

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