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非创伤性脑损伤的儿童和青少年:基于人群的视角

Children and youth with non-traumatic brain injury: a population based perspective.

作者信息

Chan Vincy, Pole Jason D, Keightley Michelle, Mann Robert E, Colantonio Angela

机构信息

Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.

Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1 V7, Canada.

出版信息

BMC Neurol. 2016 Jul 20;16:110. doi: 10.1186/s12883-016-0631-2.

Abstract

BACKGROUND

Children and youth with non-traumatic brain injury (nTBI) are often overlooked in regard to the need for post-injury health services. This study provided population-based data on their burden on healthcare services, including data by subtypes of nTBI, to provide the foundation for future research to inform resource allocation and healthcare planning for this population.

METHODS

A retrospective cohort study design was used. Children and youth with nTBI in population-based healthcare data were identified using International Classification of Diseases Version 10 codes. The rate of nTBI episodes of care, demographic and clinical characteristics, and discharge destinations from acute care and by type of nTBI were identified.

RESULTS

The rate of pediatric nTBI episodes of care was 82.3 per 100,000 (N = 17,977); the average stay in acute care was 13.4 days (SD = 25.6 days) and 35% were in intensive care units. Approximately 15% were transferred to another inpatient setting and 6% died in acute care. By subtypes of nTBI, the highest rates were among those with a diagnosis of toxic effect of substances (22.7 per 100,000), brain tumours (18.4 per 100,000), and meningitis (15.4 per 100,000). Clinical characteristics and discharge destinations from the acute care setting varied by subtype of nTBI; the proportion of patients that spent at least one day in intensive care units and the proportion discharged home ranged from 25.9% to 58.2% and from 50.6% to 76.4%, respectively.

CONCLUSIONS

Children and youth with nTBI currently put an increased demand on the healthcare system. Active surveillance of and in-depth research on nTBI, including subtypes of nTBI, is needed to ensure that timely, appropriate, and targeted care is available for this pediatric population.

摘要

背景

患有非创伤性脑损伤(nTBI)的儿童和青少年在伤后健康服务需求方面常常被忽视。本研究提供了基于人群的数据,说明他们对医疗服务的负担,包括按nTBI亚型分类的数据,为未来研究提供基础,以指导该人群的资源分配和医疗规划。

方法

采用回顾性队列研究设计。利用国际疾病分类第10版编码,在基于人群的医疗数据中识别患有nTBI的儿童和青少年。确定了nTBI护理事件发生率、人口统计学和临床特征,以及急性护理出院目的地和nTBI类型。

结果

儿科nTBI护理事件发生率为每10万人82.3例(N = 17977);急性护理平均住院时间为13.4天(标准差 = 25.6天),35%在重症监护病房。约15%被转至另一住院科室,6%在急性护理中死亡。按nTBI亚型分类,发病率最高的是诊断为物质中毒效应者(每10万人22.7例)、脑肿瘤患者(每10万人18.4例)和脑膜炎患者(每10万人15.4例)。急性护理环境中的临床特征和出院目的地因nTBI亚型而异;在重症监护病房至少住一天的患者比例和出院回家的患者比例分别在25.9%至58.2%和50.6%至76.4%之间。

结论

患有nTBI的儿童和青少年目前对医疗系统的需求增加。需要对nTBI,包括nTBI亚型进行积极监测和深入研究,以确保为该儿科人群提供及时、适当和有针对性的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d680/4955214/c5c6c9e96eae/12883_2016_631_Fig1_HTML.jpg

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