50岁及以上创伤性脑损伤成年患者共病情况的流行病学
Epidemiology of Comorbid Conditions Among Adults 50 Years and Older With Traumatic Brain Injury.
作者信息
Kumar Raj G, Juengst Shannon B, Wang Zhensheng, Dams-OʼConnor Kristen, Dikmen Sureyya S, OʼNeil-Pirozzi Therese M, Dahdah Marie N, Hammond Flora M, Felix Elizabeth R, Arenth Patricia M, Wagner Amy K
机构信息
University of Pittsburgh Department of Physical Medicine and Rehabilitation, Pittsburgh, Pennsylvania (Messrs Kumar and Wang and Drs Juengst, Arenth, and Wagner); University of Pittsburgh Department of Epidemiology, Pittsburgh, Pennsylvania (Messrs Kumar and Wang); Icahn School of Medicine at Mount Sinai, New York, NY (Dr Dams-O'Connor); University of Washington Department of Rehabilitation Medicine, Seattle (Dr Dikmen); Northeastern University Department of Communication Sciences and Disorders, Boston, Massachusetts (Dr O'Neil-Pirozzi); Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts (Dr O'Neil-Pirozzi); Baylor Scott & White Health Medical Center - Plano, TX; Baylor Institute for Rehabilitation, Dallas, TX (Dr Dahdah); Indiana University School of Medicine Department of Physical Medicine and Rehabilitation, Indianapolis, Indiana (Dr Hammond); University of Miami Department of Physical Medicine and Rehabilitation, Miami, Florida (Dr Felix); and University of Pittsburgh Center for Neuroscience, University of Pittsburgh Safar Center for Resuscitation Research, and University of Pittsburgh Department of Neuroscience, Pittsburgh, Pennsylvania (Dr Wagner).
出版信息
J Head Trauma Rehabil. 2018 Jan/Feb;33(1):15-24. doi: 10.1097/HTR.0000000000000273.
OBJECTIVES
Aging individuals with traumatic brain injury (TBI) experience multiple comorbidities that can affect recovery from injury. The objective of this study was to describe the most commonly co-occurring comorbid conditions among adults 50 years and older with TBI.
SETTING
Level I Trauma centers.
PARTICIPANTS
Adults 50 years and older with moderate/severe TBI enrolled in the TBI-Model Systems (TBI-MS) from 2007 to 2014 (n = 2134).
DESIGN
A TBI-MS prospective cohort study.
MAIN MEASURES
International Classification of Disease-9th Revision codes collapsed into 45 comorbidity categories. Comorbidity prevalence estimates and trend analyses were conducted by age strata (50-54, 55-64, 65-74, 75-84, ≥85 years). A dimension reduction method, Treelet Transform, classified clusters of comorbidities that tended to co-occur.
RESULTS
The 3 most commonly occurring comorbid categories were hypertensive disease (52.6/100 persons), other diseases of the respiratory system (51.8/100 persons), and fluid component imbalances (43.7/100 persons). Treelet Transform classified 3 clusters of comorbid codes, broadly classified as (1) acute medical diseases/infections, (2) chronic conditions, and (3) substance abuse disorders.
CONCLUSION
This study provides valuable insight into comorbid conditions that co-occur among adults 50 years and older with TBI and provides a foundation for future studies to explore how specific comorbidities affect TBI recovery.
目的
患有创伤性脑损伤（TBI）的老年人存在多种共病情况，这些情况会影响损伤后的恢复。本研究的目的是描述50岁及以上患有TBI的成年人中最常见的共病情况。
设置
一级创伤中心。
参与者
2007年至2014年纳入创伤性脑损伤模型系统（TBI-MS）的50岁及以上患有中度/重度TBI的成年人（n = 2134）。
设计
一项TBI-MS前瞻性队列研究。
主要测量指标
《国际疾病分类》第九版编码合并为45个共病类别。按年龄层（50 - 54岁、55 - 64岁、65 - 74岁、75 - 84岁、≥85岁）进行共病患病率估计和趋势分析。一种降维方法，即小波变换，对倾向于同时出现的共病聚类进行分类。
结果
3种最常见的共病类别为高血压病（每100人中有52.6人）、其他呼吸系统疾病（每100人中有51.8人）和液体成分失衡（每100人中有43.7人）。小波变换将共病编码分为3类，大致分类为：（1）急性内科疾病/感染，（2）慢性病，（3）物质滥用障碍。
结论
本研究为50岁及以上患有TBI的成年人中同时出现的共病情况提供了有价值的见解，并为未来研究探索特定共病如何影响TBI恢复奠定了基础。
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