Brau Ricardo H, Acevedo-Salas Yaritza, Giovannetti Katya
Professor, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
Program Coordinator, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
P R Health Sci J. 2018 Jun;37(2):67-77.
According to the Centers for Disease Control and Prevention (CDC), injury to the central nervous system (CNS) continues to be a leading cause of injury-related morbidity and mortality in the US today.
A prospective cohort study was performed to determine the incidence of all traumatic CNS injuries. Descriptive variables were presented as frequencies and percentages. Quantitative variables were expressed as means and averages (plus/minus standard deviation); bivariate cross-tabulation and multiple regression analyses were employed to identify risk factors and compare epidemiological patterns of injury related variables.
Information from 3,202 patients with confirmed CNS injuries was collected and analyzed. Traumatic brain injuries (TBIs) had occurred in 2,524 of the cases (78.8%). Spine injuries had occurred in 831 cases (25.9%), and 197 cases (6.2%) had suffered spinal cord injuries. Overall, most of the cases were male (75.0%) and with a median age of 40 years. Of the total number of cases, newborns and infants (<= 4 years of age) comprised 7.8% and elderly individuals (>65 years of age), 27.4%. Nearly half of the injuries were due to falls (47.5%), followed by motor vehicle and other transport accidents (35.2%). Loss of consciousness occurred in 61.3% of the traumas. The Glasgow Coma Scale (GCS) was used to categorize TBI severity and showed that the majority of TBIs were mild (70.0%). Over 90% of all cases had been injured either at home (42.8%) or on the street (49.1%).
These results are evidence that additional collaborative efforts that focus on trauma are needed to increase knowledge, public health awareness, and preventive measures.
根据美国疾病控制与预防中心（CDC）的数据，中枢神经系统（CNS）损伤仍是当今美国与损伤相关的发病和死亡的主要原因。
进行了一项前瞻性队列研究以确定所有创伤性中枢神经系统损伤的发生率。描述性变量以频率和百分比呈现。定量变量以均值和平均数（加减标准差）表示；采用双变量交叉表和多元回归分析来识别危险因素并比较损伤相关变量的流行病学模式。
收集并分析了3202例确诊中枢神经系统损伤患者的信息。其中2524例（78.8%）发生了创伤性脑损伤（TBI）。831例（25.9%）发生了脊柱损伤，197例（6.2%）发生了脊髓损伤。总体而言，大多数病例为男性（75.0%），中位年龄为40岁。在所有病例中，新生儿和婴儿（≤4岁）占7.8%，老年人（>65岁）占27.4%。近一半的损伤是由于跌倒（47.5%），其次是机动车和其他交通事故（35.2%）。61.3%的创伤患者出现了意识丧失。采用格拉斯哥昏迷量表（GCS）对TBI严重程度进行分类，结果显示大多数TBI为轻度（70.0%）。超过90%的病例是在家中（42.8%）或街道上（49.1%）受伤。
这些结果证明，需要进一步开展以创伤为重点的合作努力，以增加知识、提高公众健康意识并采取预防措施。
