Singh Rajiv, Humphries Thomas, Mason Suzanne, Lecky Fiona, Dawson Jeremy, Sinha Saurabh
a Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine , Sheffield Teaching Hospitals , Sheffield , UK.
b Health Services Research, School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry and Health , University of Sheffield , Sheffield , UK.
Brain Inj. 2018;32(9):1122-1128. doi: 10.1080/02699052.2018.1483028. Epub 2018 Jun 6.
While anosmia is common after Traumatic Brain Injury(TBI) (prevalence 4%-68%),studies differ in the associations found with other variables.
To assess the incidence of anosmia within a large, mixed TBI cohort and examine relationships with other injury or demographic features, including depression and global outcome(GOSE).
DESIGN, SUBJECTS AND SETTING: 774 consecutive TBI admissions over 2 years, assessed within a specialist neurorehabilitation clinic.
All patients assessed at 6-8 weeks and 1 year. Tools included the Extended Glasgow Outcome Scale(GOSE), Rivermead Head Injury Follow-up Questionnaire, Rivermead Post-Concussion Symptoms and the Hospital Anxiety and Depression Score. Olfactory function assessed with sensitivity to coffee granules.
The overall incidence of anosmia was 19.7%; mild TBI (9.55%), moderate (20.01%), and severe (43.5%). On a logistic regression, features of TBI severity (p < 0.001 (95% CI 0.098-0.438)), medical comorbidities (p = 0.026 (95% CI 0.301-0.927)) and depression (p = 0.006 (95% CI 1.202-2.981)) were significant. Sixty percent of patients with anosmia at 1 year were found to be clinically depressed, compared to 36% of patients without anosmia.
In the largest prospective study of post-TBI anosmia, the incidence increased with TBI severity and other medical illness. The presence of anosmia should also raise the clinical suspicion of depression.
虽然创伤性脑损伤（TBI）后嗅觉丧失很常见（患病率4%-68%），但不同研究发现的与其他变量的关联有所不同。
评估大型混合性TBI队列中嗅觉丧失的发生率，并研究其与其他损伤或人口统计学特征（包括抑郁症和总体结局（GOSE））之间的关系。
设计、研究对象与研究地点：连续两年内774例TBI住院患者，在一家专业神经康复诊所进行评估。
所有患者在6-8周和1年时进行评估。使用的工具包括扩展格拉斯哥结局量表（GOSE）、里弗米德头部损伤随访问卷、里弗米德脑震荡后症状量表以及医院焦虑抑郁量表。通过对咖啡颗粒的敏感度评估嗅觉功能。
嗅觉丧失的总体发生率为19.7%；轻度TBI为（9.55%），中度为（20.01%），重度为（43.5%）。在逻辑回归分析中，TBI严重程度（p<0.001（95%CI 0.098-0.438））、合并症（p=0.026（95%CI 0.301-0.927））和抑郁症（p=0.006（95%CI 1.202-2.981））具有显著意义。1年时嗅觉丧失患者中有60%被发现患有临床抑郁症，而无嗅觉丧失患者中这一比例为36%。
在关于TBI后嗅觉丧失的最大规模前瞻性研究中，发生率随TBI严重程度和其他疾病而增加。嗅觉丧失的存在也应增加对抑郁症的临床怀疑。
