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基于职业状况的严重创伤性脑损伤的特征和结果。

Characteristics and outcome of severe traumatic brain injuries based on occupational status.

机构信息

Department of Public Health, Institute for Global Health and Epidemiology, Faculty of Health Sciences and Social Work, Trnava University, Hornopotocna 23, 91843, Trnava, Slovakia.

Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.

出版信息

Eur J Trauma Emerg Surg. 2021 Dec;47(6):2035-2041. doi: 10.1007/s00068-020-01372-7. Epub 2020 Apr 18.

Abstract

PURPOSE

The association of TBI with socioeconomic characteristics of patients has not been studied extensively. The objective of this study was to analyse the differences in injury characteristics and outcome in TBI patients based on their occupational status.

METHODS

Data on patients from 13 centres based in Austria, Croatia, Slovakia, Bosnia and Herzegovina, and Macedonia were included in the analysis. Demographic characteristics, injury characteristics, treatment and outcome at various post-injury stages were compared according to occupational status. Logistic regression was used to adjust for the effect of co-variates. ICU mortality, hospital mortality, 6 months mortality, and outcome at 6 months were used as dependent variables.

RESULTS

Overall, 886 patients were analysed with a mean age of 45.5 years. High-level falls were most prevalent in the blue-collar group (19%), most low-level falls occurred in the retired group. Traffic accidents were most common in students. The injuries were most severe in the blue-collar group and students. Highest mortalities and unfavourable outcomes were in the retired, students and white-collar workers had the best outcomes. Compared to retired patients, all groups had higher odds of favourable outcome at 6 months after adjusting for co-variates-OR from 2.2 (95% CI 1.1-4.6) for entrepreneurs to 3.6 (95% CI 1.8-7.2) for the blue-collar group.

CONCLUSION

Our paper provides clues pertaining specifically to variations in patterns and outcomes of TBI according to occupational status which can inform prevention and planning of services and can serve to plan priorities for further research.

摘要

目的

颅脑损伤(TBI)与患者社会经济特征的关系尚未得到广泛研究。本研究旨在分析基于职业状况的 TBI 患者的损伤特征和预后差异。

方法

分析了来自奥地利、克罗地亚、斯洛伐克、波斯尼亚和黑塞哥维那以及马其顿 13 个中心的数据。根据职业状况比较了人口统计学特征、损伤特征、不同损伤后阶段的治疗和预后。使用逻辑回归调整协变量的影响。ICU 死亡率、医院死亡率、6 个月死亡率和 6 个月的预后作为因变量。

结果

共分析了 886 例患者,平均年龄为 45.5 岁。蓝领群体中高发的是高处坠落伤(19%),退休群体中高发的是低处坠落伤。交通事故在学生中最常见。损伤最严重的是蓝领群体和学生。最高的死亡率和不良预后出现在退休群体,而退休、学生和白领群体的预后最好。与退休患者相比,所有群体在调整协变量后 6 个月的预后良好的可能性更高——企业家的优势比为 2.2(95%CI 1.1-4.6),蓝领群体为 3.6(95%CI 1.8-7.2)。

结论

我们的论文提供了具体的线索,即根据职业状况,TBI 的模式和结果存在差异,这可以为预防和服务规划提供信息,并为进一步研究规划重点。

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