Luerssen T G, Klauber M R, Marshall L F
Department of Pediatrics, University of California Medical Center, San Diego.
J Neurosurg. 1988 Mar;68(3):409-16. doi: 10.3171/jns.1988.68.3.0409.
A series of 8814 head-injured patients admitted to 41 hospitals in three separate metropolitan areas were prospectively studied. Of these, 1906 patients (21.6%) were 14 years of age or less. This "pediatric population" was compared to the remaining "adult population" for mechanism of injury, admission Glasgow Coma Scale score, motor score, blood pressure, pupillary reactivity, the presence of associated injuries, and the presence of subdural or epidural hematoma. The relationship of each of these factors was then correlated with post-traumatic mortality. Except for patients found to have subdural hematoma and those who were profoundly hypotensive, the pediatric patients exhibited a significantly lower mortality rate compared to the adults, thus confirming this generally held view. This study indicates that age itself, even within the pediatric age range, is a major independent factor affecting the mortality rate in head-injured patients.
对三个不同大都市地区41家医院收治的8814例头部受伤患者进行了前瞻性研究。其中,1906例患者(21.6%)年龄在14岁及以下。将这一“儿科人群”与其余“成人人群”在受伤机制、入院时格拉斯哥昏迷量表评分、运动评分、血压、瞳孔反应性、合并伤情况以及硬膜下或硬膜外血肿情况等方面进行了比较。然后将这些因素中的每一个与创伤后死亡率进行关联。除了发现有硬膜下血肿的患者和严重低血压患者外,儿科患者的死亡率明显低于成人,从而证实了这一普遍观点。这项研究表明,即使在儿科年龄范围内,年龄本身也是影响头部受伤患者死亡率的一个主要独立因素。