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创伤性脑损伤发病率和死亡率的预测因素:国家创伤数据库数据分析:TBI 发病率和死亡率的预测因素。

Predictors of traumatic brain injury morbidity and mortality: Examination of data from the national trauma data bank: Predictors of TBI morbidity & mortality.

机构信息

Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta GA, USA.

出版信息

Injury. 2021 May;52(5):1138-1144. doi: 10.1016/j.injury.2021.01.042. Epub 2021 Jan 29.

Abstract

BACKGROUND

There is evidence to suggest that traumatic brain injuries (TBI) are increasing in the United States. It is important to examine predictors of TBI outcomes to formulate better prevention and care strategies.

RESEARCH DESIGN

National Trauma Data Bank (NTDB) data from 2016 were used to report the percentage of TBI by age, sex, race/ethnicity, health insurance status, intent/mechanism of injury, Glasgow Coma Scale (GCS), disposition at emergency department, and trauma center level. Logistic regression models were run to estimate the adjusted odds ratios of patient and facility characteristics on length of hospital stay and in-hospital mortality (analyzed in 2020).

RESULTS

There were 236,873 patients with TBI in the NTDB in 2016. Most patients with a TBI were male, non-Hispanic white, and had sustained a TBI due to an unintentional injury. After adjusting for other factors, individuals age 0-17, those who self-pay, and those with intentional injuries had increased odds of a shorter hospital stay. Older individuals, non-Hispanic black or Hispanic patients, those who had sustained an intentional injury, and those who were not seen in a Level I trauma center had higher odds of mortality following their TBI.

CONCLUSIONS

Public health professionals' promotion of fall and other TBI prevention efforts and the development of strategies to improve access to Level I trauma centers, may decrease adverse TBI health outcomes. This may be especially important for older adults and other vulnerable populations.

摘要

背景

有证据表明,美国的创伤性脑损伤(TBI)正在增加。检查 TBI 结果的预测因素对于制定更好的预防和护理策略很重要。

研究设计

使用 2016 年国家创伤数据库(NTDB)的数据报告 TBI 按年龄、性别、种族/民族、医疗保险状况、受伤意图/机制、格拉斯哥昏迷量表(GCS)、急诊室处理情况和创伤中心级别分类的百分比。运行逻辑回归模型,以估计患者和医疗机构特征对住院时间和院内死亡率的调整比值比(于 2020 年进行分析)。

结果

2016 年 NTDB 中有 236873 名 TBI 患者。大多数 TBI 患者为男性、非西班牙裔白人,因非故意损伤而遭受 TBI。在调整其他因素后,0-17 岁的个体、自费患者和有意受伤的个体住院时间更短的几率增加。年龄较大的个体、非西班牙裔黑人和西班牙裔患者、遭受故意受伤的患者以及未在一级创伤中心就诊的患者,其 TBI 后死亡的几率更高。

结论

公共卫生专业人员应加强对跌倒和其他 TBI 预防工作的宣传,并制定策略以改善对一级创伤中心的获取,这可能会降低 TBI 的不良健康后果。这对于老年人和其他弱势群体可能尤为重要。

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