Department of Radiology, Neuroradiology Section, Stanford University School of Medicine, Palo Alto, CA 94305, USA; Encephalopathy Center, Beijing Chaoyang Integrative Medicine Emergency Medical Center, Beijing 100122, China.
Department of Radiology, Neuroradiology Section, Stanford University School of Medicine, Palo Alto, CA 94305, USA; Department of Neurology, PLA Army General Hospital, Beijing 100700, China.
J Neuroradiol. 2021 Mar;48(2):104-111. doi: 10.1016/j.neurad.2019.07.002. Epub 2019 Jul 16.
To characterize the demographics, clinical and imaging findings, and outcomes of traumatic brain injury (TBI) patients in each of NeuroImaging Radiological Interpretation System (NIRIS) categories.
We considered all consecutive patients transported to Stanford Hospital's emergency department by ambulance or helicopter between November 2015 and April 2017. We retained adult patients (> 18 years old) for whom a trauma alert was triggered and who underwent a non-contrast head computer tomography (CT) because of suspected TBI. We reviewed the non-contrast CT scans in these patients for the NIH TBI common data elements (CDEs). We recorded, then assessed differences in terms of demographics, clinical characteristics, imaging CDEs, and outcomes in patients from the different NIRIS categories.
In all, 1152 patients were included in this study. Patients with NIRIS 0 imaging findings were significantly younger than patients in other NIRIS categories (P<0.001). Motor vehicle accidents and falls from height were the most common mechanisms of injury across NIRIS categories. GCS scores decreased with increasing NIRIS category imaging findings and were significantly lower in patients with NIRIS 4 imaging findings (P<0.001). Significant differences in NIRIS categories were observed for all imaging CDEs (P<0.001), in agreement with the definition of the different NIRIS categories. Mortality increased progressively with increasing NIRIS severity.
TBI patients in different NIRIS categories have different clinical characteristics, hospital courses and outcomes. This natural history assessment of patients from different NIRIS categories could thus serve as a reference standard for future TBI clinical trials.
描述神经影像放射学解读系统（NIRIS）各分类中创伤性脑损伤（TBI）患者的人口统计学、临床和影像学表现以及结局。
我们纳入了 2015 年 11 月至 2017 年 4 月间通过救护车或直升机被送往斯坦福医院急诊部的所有连续患者。我们保留了因疑似 TBI 而接受非对比头部计算机断层扫描（CT）检查的成年患者（>18 岁）。我们对这些患者的非对比 CT 扫描进行了 NIH TBI 常见数据元素（CDE）回顾。我们记录了不同 NIRIS 分类患者的人口统计学、临床特征、影像学 CDE 和结局方面的差异，并进行了评估。
共有 1152 例患者纳入本研究。NIRIS 0 影像学结果患者显著较其他 NIRIS 分类患者年轻（P<0.001）。机动车事故和高处坠落是各 NIRIS 分类中最常见的损伤机制。格拉斯哥昏迷评分（GCS）随 NIRIS 分类影像学结果的增加而降低，且 NIRIS 4 影像学结果患者的 GCS 评分显著较低（P<0.001）。各 NIRIS 分类之间的影像学 CDE 存在显著差异（P<0.001），这与不同 NIRIS 分类的定义相符。死亡率随 NIRIS 严重程度的增加而逐渐增加。
不同 NIRIS 分类的 TBI 患者具有不同的临床特征、住院过程和结局。因此，对不同 NIRIS 分类患者的这种自然史评估可作为未来 TBI 临床试验的参考标准。
