Ziaeirad Marzieh, Alimohammadi Nasrollah, Irajpour Alireza, Aminmansour Bahram
Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Nursing, Nursing and Midwifery Faculty, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
Iran J Nurs Midwifery Res. 2018 May-Jun;23(3):211-216. doi: 10.4103/ijnmr.IJNMR_65_17.
Traumatic brain injury (TBI) is a main health problem among communities. There exists a variety of effective factors on the outcome of patients with TBI. We describe the demographic, clinical, and injury related variables of the patients with severe TBI, and determine the predictors of outcome.
We did this cross-sectional study on all 267 adult patients with severe TBI admitted to three trauma centers of Isfahan University of Medical Sciences (IUMS) from March 20, 2014 to March 19, 2015. Data were extracted from patients' profiles. We considered the patients' outcome as discharged and died. We analyzed the collected data using descriptive (frequency, mean, and standard deviation) and analytical (independent -test, Mann-Whitney U-test, Kruskal-Wallis test and logistic regression) statistics in Statistical Package for the Social Sciences (SPSS) 16.0. We considered < 0.05 as the significance level.
The mean (SD) age of patients was 43.86 (18.40) years. The majority of the population was men (87.27%). Road traffic accidents (RTAs) were the most common mechanism of trauma (79.40%). The mean (SD) of Glasgow coma scale (GCS) was 6.03 (3.11). In 50.19% of the patients, the pupillary reflex was absent. One hundred and twenty-four patients (46.44%) died before discharge. We found age, gender, GCS, pupillary reflex, hypernatremia, and increased intracranial pressure (IICP) as the predictors of death in severe TBI.
In this study, the mortality rate of patients with severe TBI was high. In addition, some factors were determined as the significant predictors of outcome. The findings can assist in planning to enhance the quality of care and reduce the mortality rate in the patients with severe TBI.
创伤性脑损伤（TBI）是社区中的一个主要健康问题。TBI患者的预后存在多种影响因素。我们描述了重度TBI患者的人口统计学、临床和损伤相关变量，并确定了预后的预测因素。
我们对2014年3月20日至2015年3月19日入住伊斯法罕医科大学（IUMS）三个创伤中心的所有267例成年重度TBI患者进行了这项横断面研究。数据从患者病历中提取。我们将患者的预后分为出院和死亡。我们使用社会科学统计软件包（SPSS）16.0中的描述性统计（频率、均值和标准差）和分析性统计（独立样本t检验、曼-惠特尼U检验、克鲁斯卡尔-沃利斯检验和逻辑回归）对收集到的数据进行分析。我们将P<0.05视为显著性水平。
患者的平均（标准差）年龄为43.86（18.40）岁。大多数患者为男性（87.27%）。道路交通事故（RTA）是最常见的创伤机制（79.40%）。格拉斯哥昏迷量表（GCS）的平均（标准差）评分为6.03（3.11）。50.19%的患者瞳孔反射消失。124例患者（46.44%）在出院前死亡。我们发现年龄、性别、GCS、瞳孔反射、高钠血症和颅内压升高（IICP）是重度TBI患者死亡的预测因素。
在本研究中，重度TBI患者的死亡率较高。此外，一些因素被确定为预后的重要预测因素。这些发现有助于规划提高护理质量并降低重度TBI患者的死亡率。
