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急诊科创伤性脑损伤的流行病学研究

An Epidemiologic Study of Traumatic Brain Injuries in Emergency Department.

作者信息

Monsef Kasmaei Vahid, Asadi Payman, Zohrevandi Behzad, Raouf Mohammad Taghi

机构信息

Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Emerg (Tehran). 2015 Fall;3(4):141-5.

Abstract

INTRODUCTION

Traumatic brain injuries (TBI) are one of the most important causes of death in patients under the age of 25 years and is responsible for one third of total deaths caused by trauma. Therefore, knowing its epidemiologic pattern in different populations seems vital. Therefore, this study aims to examine the epidemiologic pattern of TBI in emergency department.

METHODS

In this cross-sectional study, the profiles of 1000 patients affected by TBI were selected using simple random sampling. The examined variables in this study included demographic, season, mechanism of injury, accompanying injuries, level of consciousness, hospitalization duration, computed tomography (CT) scan results, needing surgery, admission to intensive care unit, and outcome of the patient. In the end, independent risk factors for the death of patients were determined.

RESULTS

1000 patients suffering from were studied (81.8% male; mean age 38.5±21.7 years). The frequency of their referral to hospital in spring (31.4%) was more (p<0.01). 45.9% of the patients had a level of consciousness less than 9 based on the Glasgow Coma Scale (GCS). Subdural (45.9%) and epidural bleeding (23.7%) were the most common findings in CT scans in this study (p<0.001). Finally, 233 (23.3%) of the patients were dead. Over 60 years of age, falling and motorcycle accidents, intracranial hemorrhage accompanied by brain contusion, subdural bleeding, a GCS of less than 9, and the need to be admitted to intensive care unit were independent risk factors of death in TBI.

CONCLUSION

Age Over 60 years, falling and motorcycle accidents, intracranial hemorrhage accompanied by brain contusion, subdural bleeding, a GCS of less than 9, and need to be admitted to intensive care unit were independent risk factors for the death in TBI patients.

摘要

引言

创伤性脑损伤(TBI)是25岁以下患者最重要的死亡原因之一,占创伤所致总死亡人数的三分之一。因此,了解其在不同人群中的流行病学模式似乎至关重要。因此,本研究旨在探讨急诊科创伤性脑损伤的流行病学模式。

方法

在这项横断面研究中,采用简单随机抽样的方法选取了1000例创伤性脑损伤患者的资料。本研究中检测的变量包括人口统计学、季节、损伤机制、伴随损伤、意识水平、住院时间、计算机断层扫描(CT)结果、是否需要手术、入住重症监护病房情况以及患者的结局。最后,确定了患者死亡的独立危险因素。

结果

共研究了1000例患者(男性占81.8%;平均年龄38.5±21.7岁)。他们在春季转诊至医院的频率更高(31.4%)(p<0.01)。根据格拉斯哥昏迷量表(GCS),45.9%的患者意识水平低于9分。硬膜下出血(45.9%)和硬膜外出血(23.7%)是本研究CT扫描中最常见的发现(p<0.001)。最后,233例(23.3%)患者死亡。60岁以上、跌倒和摩托车事故、伴有脑挫伤的颅内出血、硬膜下出血、GCS低于9分以及需要入住重症监护病房是创伤性脑损伤患者死亡的独立危险因素。

结论

60岁以上、跌倒和摩托车事故、伴有脑挫伤的颅内出血、硬膜下出血、GCS低于9分以及需要入住重症监护病房是创伤性脑损伤患者死亡的独立危险因素。

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