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老年人轻度脑外伤的管理:文献综述

Management of Mild Brain Trauma in the Elderly: Literature Review.

作者信息

Marrone Federica, Zavatto Luca, Allevi Mario, Di Vitantonio Hambra, Millimaggi Daniele Francesco, Dehcordi Soheila Raysi, Ricci Alessandro, Taddei Graziano

机构信息

Department of Neurosurgery, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.

Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.

出版信息

Asian J Neurosurg. 2020 Dec 21;15(4):809-820. doi: 10.4103/ajns.AJNS_205_20. eCollection 2020 Oct-Dec.

DOI:10.4103/ajns.AJNS_205_20
PMID:33708648
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7869288/
Abstract

PURPOSE

The world population is aging. As direct consequence, geriatric trauma is increasing both in absolute number and in the proportion of annual admissions causing a challenge for the health-care system worldwide. The aim of this review is to delineate the specific and practice rules for the management of mild brain trauma in the elderly.

METHODS

Systematic review of the last 15 years literature on mild traumatic brain injury (nTBI) in elderly patients.

RESULTS

A total of 68 articles ml eligibility criteria and were selected for the systematic review. We collected 29% high-quality studies and 71% low-quality studies.

CONCLUSION

Clinical advices for a comprehensive management are provided. Current outcome data from mTBIs in the elderly show a condition that cannot be sustained in the future by families, society, and health-care systems. There is a strong need for more research on geriatric mild brain trauma addressed to prevent falls, to reduce the impact of polypharmacy, and to define specific management strategies.

摘要

目的

世界人口正在老龄化。直接结果是,老年创伤患者的数量及其在每年住院患者中所占的比例都在增加,这给全球医疗保健系统带来了挑战。本综述的目的是阐述老年轻度脑外伤的具体管理方法和实践规则。

方法

对过去15年有关老年患者轻度创伤性脑损伤(nTBI)的文献进行系统综述。

结果

共有68篇文章符合纳入标准并被选入系统综述。我们收集到29%的高质量研究和71%的低质量研究。

结论

提供了全面管理的临床建议。目前老年mTBI的结局数据显示,这种情况在未来家庭、社会和医疗保健系统都无法承受。迫切需要针对老年轻度脑外伤开展更多研究,以预防跌倒、减少多重用药的影响并确定具体的管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/207e/7869288/e83e2400c8a7/AJNS-15-809-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/207e/7869288/9722ae97d31a/AJNS-15-809-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/207e/7869288/ce7bc600cd64/AJNS-15-809-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/207e/7869288/e83e2400c8a7/AJNS-15-809-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/207e/7869288/9722ae97d31a/AJNS-15-809-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/207e/7869288/ce7bc600cd64/AJNS-15-809-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/207e/7869288/e83e2400c8a7/AJNS-15-809-g003.jpg

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J Neurosurg. 2019 Jul 5;133(2):486-495. doi: 10.3171/2019.4.JNS19252. Print 2020 Aug 1.
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Delayed intracranial hemorrhage in elderly anticoagulated patients sustaining a minor fall.老年抗凝患者轻微跌倒后发生的迟发性颅内出血。
BMC Emerg Med. 2018 Aug 24;18(1):27. doi: 10.1186/s12873-018-0179-0.
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Direct oral anticoagulants do not worsen traumatic brain injury after low-level falls in the elderly.
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Acta Neurochir (Wien). 2024 Sep 11;166(1):363. doi: 10.1007/s00701-024-06247-z.
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A Diagnostic Model for Alzheimer's Disease Based on Blood Levels of Autophagy-Related Genes.基于自噬相关基因血液水平的阿尔茨海默病诊断模型
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Characteristics of fall-related traumatic brain injury in older adults.老年人跌倒相关创伤性脑损伤的特征。
Intern Med J. 2018 Sep;48(9):1048-1055. doi: 10.1111/imj.13794.
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Incidence of Delayed Intracranial Hemorrhage in Older Patients After Blunt Head Trauma.钝性头部外伤后老年患者迟发性颅内出血的发生率。
JAMA Surg. 2018 Jun 1;153(6):570-575. doi: 10.1001/jamasurg.2017.6159.
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Mild brain injury and anticoagulants: Less is enough.轻度脑损伤与抗凝剂:用量越少越好。
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