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轻度创伤性脑损伤患者痴呆风险增加:一项全国性队列研究。

Increased risk of dementia in patients with mild traumatic brain injury: a nationwide cohort study.

机构信息

Emergency Department, Buddhist Tzu Chi Dalin General Hospital, Chiayi, Taiwan.

出版信息

PLoS One. 2013 May 1;8(5):e62422. doi: 10.1371/journal.pone.0062422. Print 2013.

Abstract

BACKGROUND

It is known that the risk of dementia in patients with moderate to severe traumatic brain injury (TBI) is higher. However, the relationship between mild traumatic brain injury (mTBI) and dementia has never been established.

OBJECTIVES

We investigated the incidences of dementia among patients with mTBI in Taiwan to evaluate if there is higher risk compared with general population.

METHODS

We utilized a sampled National Health Insurance (NHI) claims data containing one million beneficiaries. We followed all adult beneficiaries from January 1, 2005 till December 31, 2009 to see if they had been diagnosed with dementia. We further identify patients with mTBI and compared their risk of dementia with the general population.

RESULTS

We identified 28551 patients with mTBI and 692382 without. After controlled for age, gender, urbanization level, socioeconomic status, diabetes, hypertension, coronary artery disease, hyperlipidemia, history of alcohol intoxication, history of ischemic stroke, history of intracranial hemorrhage and Charlson Comorbidity Index Score, the adjusted hazard ratio is 3.26 (95% Confidence interval, 2.69-3.94).

CONCLUSIONS

TBI is an independent significant risk factor of developing dementia even in the mild type.

摘要

背景

众所周知,中度至重度创伤性脑损伤(TBI)患者痴呆的风险更高。然而,轻度创伤性脑损伤(mTBI)与痴呆之间的关系尚未确定。

目的

我们调查了台湾 mTBI 患者的痴呆发生率,以评估与一般人群相比是否存在更高的风险。

方法

我们利用抽样的全民健康保险(NHI)理赔数据,其中包含 100 万受益人的数据。我们从 2005 年 1 月 1 日至 2009 年 12 月 31 日随访所有成年受益人,以确定他们是否被诊断患有痴呆症。我们进一步确定 mTBI 患者,并将他们患痴呆症的风险与一般人群进行比较。

结果

我们确定了 28551 例 mTBI 患者和 692382 例无 mTBI 患者。在控制年龄、性别、城市化水平、社会经济地位、糖尿病、高血压、冠状动脉疾病、高血脂、酒精中毒史、缺血性中风史、颅内出血史和 Charlson 合并症指数评分后,调整后的危险比为 3.26(95%置信区间,2.69-3.94)。

结论

TBI 是导致痴呆的独立危险因素,即使是轻度 TBI 也是如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b37/3641064/5a1465793d40/pone.0062422.g001.jpg

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