Julien Jessica, Alsideiri Ghusn, Marcoux Judith, Hasen Mohammed, Correa José A, Feyz Mitra, Maleki Mohammed, de Guise Elaine
Department of Psychology, University of Montreal, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada.
Montreal Neurological Institute & Hospital, McGill University, Canada.
J Clin Neurosci. 2017 Apr;38:122-125. doi: 10.1016/j.jocn.2016.12.032. Epub 2017 Jan 16.
The purpose of this study is to investigate the effect of risk factors including International Normalized Ratio (INR) as well as the Partial Thromboplastin Time (PTT) scores on several outcomes, including hospital length of stay (LOS) and The Extended Glasgow Outcome Scale (GOSE) following TBI in the elderly population.
Data were retrospectively collected on patients (n=982) aged 65 and above who were admitted post TBI to the McGill University Health Centre-Montreal General Hospital from 2000 to 2011. Age, Injury Severity Score (ISS), Glasgow Coma Scale score (GCS), type of trauma (isolated TBI vs polytrauma including TBI), initial CT scan results according to the Marshall Classification and the INR and PTT scores and prescriptions of antiplatelet or anticoagulant agents (AP/AC) were collected.
Results also indicated that age, ISS and GSC score have an effect on the GOSE score. We also found that taking AC/AP has an effect on GOSE outcome, but that this effects depends on PTT, with lower odds of a worse outcome for those taking AC/AP agents as the PTT value goes up. However, this effect only becomes significant as the PTT value reaches 60 and above.
Age and injury severity rather than antithrombotic agent intake are associated with adverse acute outcome such as GOSE in hospitalized elderly TBI patients.
本研究的目的是调查包括国际标准化比值（INR）以及部分凝血活酶时间（PTT）评分在内的风险因素对老年人群创伤性脑损伤（TBI）后多种结局的影响，这些结局包括住院时间（LOS）和扩展格拉斯哥预后量表（GOSE）。
回顾性收集了2000年至2011年期间因TBI入住麦吉尔大学健康中心 - 蒙特利尔总医院的982例65岁及以上患者的数据。收集了年龄、损伤严重程度评分（ISS）、格拉斯哥昏迷量表评分（GCS）、创伤类型（单纯TBI与包括TBI的多发伤）、根据马歇尔分类法得出的初始CT扫描结果以及INR和PTT评分以及抗血小板或抗凝剂（AP/AC）的处方。
结果还表明年龄、ISS和GSC评分对GOSE评分有影响。我们还发现服用AC/AP对GOSE结局有影响，但这种影响取决于PTT，随着PTT值升高，服用AC/AP药物的患者出现更差结局的几率降低。然而，只有当PTT值达到60及以上时，这种影响才变得显著。
在住院老年TBI患者中，年龄和损伤严重程度而非抗血栓药物的使用与不良急性结局如GOSE相关。
