BCVI 在单一州创伤中心的流行病学。
The epidemiology of BCVI at a single state trauma centre.
机构信息
Department of Neurosurgery, Alfred Hospital, Prahran, Victoria, Australia.
出版信息
Injury. 2010 Sep;41(9):929-34. doi: 10.1016/j.injury.2010.03.006. Epub 2010 Apr 2.
BACKGROUND
Blunt carotid and vertebral artery injury (BCVI) is a relatively uncommon but potentially devastating injury. The aim of our study was to highlight the incidence, patterns, presentation and associations of BCVI at our institution.
METHODS
Retrospective data between 1st January 2003 and 31st December 2006 was obtained from The Alfred Hospital's health information system, patient medical records and the Department of Neurosurgery's database. Injuries were graded using the Denver grading scale.
RESULTS
67 patients (0.64%) out of 10,417 minor and major trauma admissions, were diagnosed with BCVI. 33 (49%) sustained blunt carotid and 34 (51%) sustained blunt vertebral injuries. Motor vehicle accident (MVA) was the cause in 43 out of 67. 35% had associated head injury whilst 57% had concurrent cervical spine fractures. Odds ratio analysis showed that MVA victims with concomitant upper cervical spine injury were 22.9 times more likely to suffer BCVI than those without such risk factors. Approximately 50% of patients had a Glasgow coma score of 14 or less (GCS < or = 14). Grade 4 BCVI was most common. Stroke occurred in 22 (32%) and mortality in 14 (20%).
CONCLUSION
BCVI although infrequent, is a serious injury. Our study suggests that MVA patients with cervical spine fractures especially of the upper C-spine are at much higher risk of BCVI than those without such injuries.
背景
钝性颈动脉和椎动脉损伤（BCVI）是一种相对少见但潜在破坏性很强的损伤。我们的研究旨在强调我们机构中 BCVI 的发生率、类型、表现和关联。
方法
从 The Alfred Hospital 的健康信息系统、患者病历和神经外科数据库中获取了 2003 年 1 月 1 日至 2006 年 12 月 31 日期间的回顾性数据。损伤采用丹佛分级量表进行分级。
结果
在 10417 例轻、重伤患者中，有 67 例（0.64%）诊断为 BCVI。33 例（49%）发生钝性颈动脉损伤，34 例（51%）发生钝性椎动脉损伤。43 例（64%）由机动车事故（MVA）引起。35%有合并性头部损伤，57%有同时性颈椎骨折。比值比分析表明，伴有上颈椎损伤的 MVA 受害者发生 BCVI 的可能性是没有这些危险因素的受害者的 22.9 倍。约有 50%的患者格拉斯哥昏迷评分（GCS）为 14 或更低（GCS≤14）。BCVI 最常见的等级为 4 级。22 例（32%）发生中风，14 例（20%）死亡。
结论
BCVI 虽然不常见，但却是一种严重的损伤。我们的研究表明，MVA 患者尤其是颈椎骨折，特别是上颈椎骨折，发生 BCVI 的风险比没有此类损伤的患者高得多。
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