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创伤性脑损伤后白天过度嗜睡。

Excessive daytime sleepiness after traumatic brain injury.

作者信息

Crichton Thomas, Singh Rajiv, Abosi-Appeadu Kessewa, Dennis Gary

机构信息

Department of Neuroscience, University of Sheffield , Sheffield, UK.

Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine, Sheffield Teaching Hospitals , Sheffield, UK.

出版信息

Brain Inj. 2020 Sep 18;34(11):1525-1531. doi: 10.1080/02699052.2020.1810316. Epub 2020 Aug 24.

Abstract

STUDY OBJECTIVES

To identify the prevalence of excessive daytime sleepiness (EDS) in a prospectively recruited patient population with traumatic brain injury (TBI) of mixed severity. Furthermore, the study aimed to assess the relationship between patient factors and EDS.

METHOD

One-hundred and eighteen patients with TBI were assessed in a neurorehabilitation clinic after discharge from the emergency department. Enrolled participants were evaluated using several TBI-related outcome measures, 6-8 weeks after injury.

RESULTS

EDS (defined using the Epworth Sleepiness Scale ≥10) occurred in 48 of 118 (41.7%) patients in this study. Anxiety; depression; change in ability to work; employment status; global outcome (GOSE); social and functional outcome (RHFUQ); and symptom severity (RPCS) were associated with EDS in a univariate analysis. Anxiety was the only factor associated with EDS in the multivariate analysis (OR: 0.28 [95% CI: 0.09-0.90], = .032).

CONCLUSION

EDS is common after TBI in a community setting and is associated with several factors, which likely interact to contribute toward worse outcome. Anxiety is a factor that, if routinely assessed and considered during patient care choices, may assist in favorable sleep-related outcome during and after post-TBI recovery.

摘要

研究目的

确定前瞻性招募的不同严重程度创伤性脑损伤(TBI)患者群体中白天过度嗜睡(EDS)的患病率。此外,该研究旨在评估患者因素与EDS之间的关系。

方法

118例TBI患者在从急诊科出院后在神经康复诊所接受评估。在受伤6 - 8周后,使用几种与TBI相关的结局指标对纳入的参与者进行评估。

结果

在本研究的118例患者中,有48例(41.7%)出现EDS(使用爱泼华嗜睡量表定义为≥10)。在单因素分析中,焦虑、抑郁、工作能力变化、就业状况、总体结局(GOSE)、社会和功能结局(RHFUQ)以及症状严重程度(RPCS)与EDS相关。在多因素分析中,焦虑是与EDS相关的唯一因素(比值比:0.28 [95%置信区间:0.09 - 0.90],P = 0.032)。

结论

在社区环境中,TBI后EDS很常见,并且与几个因素相关,这些因素可能相互作用导致更差的结局。焦虑是一个因素,如果在患者护理选择过程中进行常规评估和考虑,可能有助于TBI恢复期间及之后与睡眠相关的良好结局。

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