Paget Louis-Marie, Boutonnet Mathieu, Moyer Jean-Denis, Delhaye Nathalie, D'Aranda Erwan, Beltzer Nathalie, Hamada Sophie Rym
Direction des maladies non transmissibles et traumatismes, Santé publique France, 12, rue du Val d'Osne, 94415 Saint-Maurice, France.
Department of Anaesthesiology and Intensive Care, Percy Military Teaching Hospital, 101, avenue Henri Barbusse, BP 406, 92141 Clamart cedex, France.
Anaesth Crit Care Pain Med. 2021 Feb;40(1):100804. doi: 10.1016/j.accpm.2021.100804. Epub 2021 Jan 22.
In France, there is a lack of recent data on Traumatic brain injury (TBI), remaining a major global health challenge in terms of morbidity and mortality. The present study reports the epidemiology and the factors associated with mortality of patients with TBI admitted to 9 French trauma centres.
Patients ≥ 15 years old admitted, between the 1 of January and the 31 of December 2017, following TBI (Abbreviated Injury Scale head ≥ 2) were included. Descriptive analyses were carried out and a logistic regression was used in order to identify in-hospital mortality predictors.
1,177 patients (889 males (76%), median age 42 [26-59]) were admitted following TBI. Road traffic accidents were the primary mechanism of TBI. Mechanisms leading to TBI were highly correlated with age. The in-hospital mortality was 23%. In-hospital mortality increased with age, from 15% in 15-24-year-olds to 71% among patients aged 85 years and older. Age, relevant past medical history, Glasgow coma scale motor score, subdural haematoma, systolic arterial blood pressure < 110 mmHg, pupillary abnormality and haemoglobin level were significantly associated with in-hospital mortality.
TBI is still a major public health concern affecting mostly young patients, victims of road traffic accidents and elderly patients, victims of falls. These findings could help clinicians adjusting medical approaches, targeting prevention measures and planning new research projects according to these French TBI population characteristics.
在法国,缺乏关于创伤性脑损伤(TBI)的最新数据,TBI在发病率和死亡率方面仍然是一项重大的全球健康挑战。本研究报告了法国9家创伤中心收治的TBI患者的流行病学情况及与死亡率相关的因素。
纳入2017年1月1日至12月31日期间因TBI(简明损伤定级标准头部损伤≥2级)入院的15岁及以上患者。进行了描述性分析,并使用逻辑回归来确定院内死亡预测因素。
1177例患者(889例男性(76%),中位年龄42岁[26 - 59岁])因TBI入院。道路交通事故是TBI的主要致伤机制。导致TBI的机制与年龄高度相关。院内死亡率为23%。院内死亡率随年龄增加而上升,从15 - 24岁患者中的15%升至85岁及以上患者中的71%。年龄、相关既往病史、格拉斯哥昏迷量表运动评分、硬膜下血肿、收缩压<110 mmHg、瞳孔异常和血红蛋白水平与院内死亡率显著相关。
TBI仍然是一个主要的公共卫生问题,主要影响年轻患者(道路交通事故受害者)和老年患者(跌倒受害者)。这些发现有助于临床医生根据这些法国TBI人群特征调整医疗方法、针对性地采取预防措施并规划新的研究项目。