黎巴嫩创伤性脑损伤的流行病学与临床特征：一项系统综述
Epidemiology and clinical characteristics of traumatic brain injury in Lebanon: A systematic review.
作者信息
Abou-Abbass Hussein, Bahmad Hisham, Ghandour Hiba, Fares Jawad, Wazzi-Mkahal Rayyan, Yacoub Basel, Darwish Hala, Mondello Stefania, Harati Hayat, El Sayed Mazen J, Tamim Hani, Kobeissy Firas
机构信息
Clinical Research Institute, Department of Internal Medicine, American University of Beirut Medical Center Faculty of Medicine, Beirut Arab University Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut Faculty of Medicine, American University of Beirut Medical Center Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University Faculty of Medicine-Hariri School of Nursing, American University of Beirut, Beirut, Lebanon Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy Department of Emergency Medicine, American University of Beirut Medical Center Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
出版信息
Medicine (Baltimore). 2016 Nov;95(47):e5342. doi: 10.1097/MD.0000000000005342.
BACKGROUND
Traumatic brain injury (TBI) is a debilitating medical and emerging public health problem that is affecting people worldwide due to a multitude of factors including both domestic and war-related acts. The objective of this paper is to systematically review the status of TBI in Lebanon - a Middle Eastern country with a weak health system that was chartered by several wars and intermittent outbursts of violence - in order to identify the present gaps in knowledge, direct future research initiatives and to assist policy makers in planning progressive and rehabilitative policies.
METHODS
OVID/Medline, PubMed, Scopus databases and Google Scholar were lastly searched on April 15, 2016 to identify all published research studies on TBI in Lebanon. Studies published in English, Arabic or French that assessed Lebanese patients afflicted by TBI in Lebanon were warranting inclusion in this review. Case reports, reviews, biographies and abstracts were excluded. Throughout the whole review process, reviewers worked independently and in duplicate during study selection, data abstraction and methodological assessment using the Downs and Black Checklist.
RESULTS
In total, 11 studies were recognized eligible as they assessed Lebanese patients afflicted by TBI on Lebanese soils. Considerable methodological variation was found among the identified studies. All studies, except for two that evaluated domestic causes such as falls, reported TBI due to war-related injuries. Age distribution of TBI victims revealed two peaks, young adults between 18 and 40 years, and older adults aged 60 years and above, where males constituted the majority. Only three studies reported rates of mild TBI. Mortality, rehabilitation and systemic injury rates were rarely reported and so were the complications involved; infections were an exception.
CONCLUSION
Apparently, status of TBI in Lebanon suffers from several gaps which need to be bridged through implementing more basic, epidemiological, clinical and translational research in this field in the future.
背景
创伤性脑损伤（TBI）是一个使人衰弱的医学问题，且正成为一个公共卫生问题，由于包括家庭和战争相关行为在内的多种因素，它正在影响着世界各地的人们。本文的目的是系统回顾黎巴嫩的创伤性脑损伤状况，黎巴嫩是一个中东国家，其卫生系统薄弱，经历了多次战争和间歇性暴力冲突，旨在找出目前知识上的差距，指导未来的研究计划，并协助政策制定者规划进步和康复政策。
方法
2016年4月15日最后一次检索了OVID/Medline、PubMed、Scopus数据库和谷歌学术，以识别所有已发表的关于黎巴嫩创伤性脑损伤的研究。以英文、阿拉伯文或法文发表的评估黎巴嫩境内受创伤性脑损伤影响的黎巴嫩患者的研究有资格纳入本综述。病例报告、综述、传记和摘要被排除。在整个综述过程中，评审人员在研究选择、数据提取和使用唐斯和布莱克清单进行方法学评估时独立且重复地工作。
结果
总共11项研究被认为符合条件，因为它们评估了黎巴嫩境内受创伤性脑损伤影响的黎巴嫩患者。在所识别的研究中发现了相当大的方法学差异。除了两项评估跌倒等家庭原因导致的创伤性脑损伤的研究外，所有研究都报告了与战争相关伤害导致的创伤性脑损伤。创伤性脑损伤受害者的年龄分布显示出两个高峰，18至40岁的年轻人和60岁及以上的老年人，其中男性占多数。只有三项研究报告了轻度创伤性脑损伤的发生率。死亡率、康复率和全身损伤率很少被报告，所涉及的并发症也是如此；感染是个例外。
结论
显然，黎巴嫩的创伤性脑损伤状况存在几个差距，未来需要通过在该领域开展更多基础、流行病学、临床和转化研究来加以弥补。
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