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创伤性脑损伤患者的院前管理——性别视角

Prehospital management of traumatic brain injury patients--a gender perspective.

作者信息

Falk Ann-Charlotte, Alm Annika, Lindström Veronica

机构信息

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.

出版信息

Int Emerg Nurs. 2015 Jul;23(3):250-3. doi: 10.1016/j.ienj.2015.01.003. Epub 2015 Jan 12.

Abstract

BACKGROUND

Studies show that there are differences between men and women when it comes to several aspects of health care. But the research on equal care in a prehospital setting for patients with severe traumatic brain injury (TBI) has been sparsely investigated. The aim of this study is to describe prehospital care from a gender perspective.

METHOD

This is a retrospective study of (n = 651) patients (>15 years) with severe TBI requiring intensive care at a University Hospital in Sweden during the years 2000-2010. Outcome was measured by survival and Glasgow Outcome Scale (GOS) scores at discharge.

RESULT

Our results show differences, though not significant, in the initial assessments and performed interventions between male and female TBI patients. Female patients received more assessments and performed interventions compared to men during prehospital care. Men received more interventions with I.V. fluid but significantly less airway interventions (endotracheal intubation) compared to female patients. More men were transported directly to neurosurgical specialist care as compared to females. No difference in outcome was found.

CONCLUSION

Our results show differences, however not significant in the assessments and performed interventions between gender, with female patients receiving more assessments and interventions compared to male patients during prehospital care. Future research should focus on gender differences in initial early signs of TBI to improve early identification.

摘要

背景

研究表明,在医疗保健的几个方面,男性和女性存在差异。但关于院前环境中重度创伤性脑损伤(TBI)患者平等护理的研究却很少。本研究的目的是从性别角度描述院前护理情况。

方法

这是一项对2000年至2010年期间在瑞典一家大学医院需要重症监护的651例(年龄>15岁)重度TBI患者进行的回顾性研究。结局通过出院时的生存率和格拉斯哥预后量表(GOS)评分来衡量。

结果

我们的结果显示,男性和女性TBI患者在初始评估和实施的干预措施方面存在差异,不过并不显著。在院前护理中,女性患者接受的评估和实施的干预措施比男性更多。男性接受的静脉输液干预更多,但与女性患者相比,气道干预(气管插管)明显更少。与女性相比,更多男性被直接转运至神经外科专科护理。未发现结局存在差异。

结论

我们的结果显示,性别之间在评估和实施的干预措施方面存在差异,但不显著,在院前护理中女性患者比男性患者接受更多的评估和干预。未来的研究应关注TBI初始早期体征的性别差异,以改善早期识别。

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