Giner J, Mesa Galán L, Yus Teruel S, Guallar Espallargas M C, Pérez López C, Isla Guerrero A, Roda Frade J
Servicio de Neurocirugía, Hospital Universitario la Paz, Madrid, España.
Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, España.
Neurologia (Engl Ed). 2022 Jun;37(5):383-389. doi: 10.1016/j.nrl.2019.03.012. Epub 2019 May 29.
Traumatic brain injury (TBI) is one of the leading causes of death and disability globally. We present a study describing epidemiological changes in severe TBI and the impact these changes have had on management and analysing alternatives that may improve outcomes in this new population.
We performed a retrospective, descriptive, cross-sectional analysis of patients presenting severe TBI at our hospital in the period of 1992-1996 and 2009-2013. We analysed demographic data, including age, sex, mortality, aetiology, anticoagulation, treatment, and functional outcome.
We reviewed data from 220 patients. In the second cohort, there were 40% fewer patients, mean age was 12years older, patients were more frequently receiving anticoagulation therapy, and the percentage of interventions was halved. Aetiology varied, with traffic accidents being the main cause in the first group, and accidental falls and being hit by cars in the second group. There were no intergroup differences for mortality or functional outcomes.
The age of patients admitted due to severe TBI has increased. As a result of this, the main cause of severe TBI in our population is accidental falls in elderly, anticoagulated patients. Despite the low-energy nature of trauma, patients in the second cohort presented a poorer baseline status, and were less frequently eligible for surgery, with no improvement in mortality or functional outcomes.
创伤性脑损伤（TBI）是全球范围内死亡和残疾的主要原因之一。我们开展了一项研究，描述重度TBI的流行病学变化以及这些变化对治疗的影响，并分析可能改善这一新增患者群体预后的替代方案。
我们对1992 - 1996年以及2009 - 2013年期间在我院就诊的重度TBI患者进行了回顾性、描述性横断面分析。我们分析了人口统计学数据，包括年龄、性别、死亡率、病因、抗凝情况、治疗及功能转归。
我们回顾了220例患者的数据。在第二个队列中，患者数量减少了40%，平均年龄大12岁，患者接受抗凝治疗的频率更高，干预措施的比例减半。病因有所不同，第一组中交通事故是主要原因，第二组中意外跌倒和被汽车撞击是主要原因。在死亡率或功能转归方面，两组之间没有差异。
因重度TBI入院的患者年龄有所增加。因此，在我们的患者群体中，重度TBI的主要原因是老年抗凝患者的意外跌倒。尽管创伤能量较低，但第二个队列中的患者基线状态较差，接受手术的频率较低，死亡率和功能转归均未改善。
