Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China.
Int J Med Sci. 2021 Feb 5;18(7):1639-1647. doi: 10.7150/ijms.54913. eCollection 2021.
The purpose of this study was to investigate whether routine blood tests on admission and clinical characteristics can predict prognosis in patients with traumatic brain injury (TBI) combined with extracranial trauma. Clinical data of 182 patients with TBI combined with extracranial trauma from April 2018 to December 2019 were retrospectively collected and analyzed. Based on GOSE score one month after discharge, the patients were divided into a favorable group (GOSE 1-4) and unfavorable group (GOSE 5-8). Routine blood tests on admission and clinical characteristics were recorded. Overall, there were 48 (26.4%) patients with unfavorable outcome and 134 (73.6%) patients with favorable outcome. Based on multivariate analysis, independent risk factors associated with unfavorable outcome were age (odds ratio [OR], 1.070; 95% confidence interval [CI], 1.018-1.124; 0.01), admission Glasgow Coma Scale (GCS) score (OR, 0.807; 95% CI, 0.675-0.965; 0.05), heart rate (OR, 1.035; 95% CI, 1.004-1.067; 0.05), platelets count (OR, 0.982; 95% CI, 0.967-0.997; 0.05), and tracheotomy (OR, 15.201; 95% CI, 4.121-56.078; 0.001). Areas under the curve (AUC) of age, admission GCS, heart rate, tracheotomy, and platelets count were 0.678 (95% CI, 0.584-0.771), 0.799 (95% CI, 0.723-0.875), 0.652 (95% CI, 0.553-0.751), 0.776 (95% CI, 0.692-0.859), and 0.688 (95% CI, 0.606-0.770), respectively. Age, admission GCS score, heart rate, tracheotomy, and platelets count can be recognized as independent predictors of clinical prognosis in patients with severe TBI combined with extracranial trauma.
本研究旨在探讨入院时常规血液检查和临床特征是否可以预测创伤性脑损伤（TBI）合并颅外创伤患者的预后。回顾性收集并分析了 2018 年 4 月至 2019 年 12 月间 182 例 TBI 合并颅外创伤患者的临床资料。根据出院后 1 个月的 GOSE 评分，将患者分为预后良好组（GOSE 1-4）和预后不良组（GOSE 5-8）。记录入院时的常规血液检查和临床特征。总体而言，48 例（26.4%）患者预后不良，134 例（73.6%）患者预后良好。多因素分析显示，与预后不良相关的独立危险因素为年龄（比值比[OR]，1.070；95%置信区间[CI]，1.018-1.124；0.01）、入院时格拉斯哥昏迷评分（OR，0.807；95%CI，0.675-0.965；0.05）、心率（OR，1.035；95%CI，1.004-1.067；0.05）、血小板计数（OR，0.982；95%CI，0.967-0.997；0.05）和气管切开术（OR，15.201；95%CI，4.121-56.078；0.001）。年龄、入院 GCS、心率、气管切开术和血小板计数的曲线下面积（AUC）分别为 0.678（95%CI，0.584-0.771）、0.799（95%CI，0.723-0.875）、0.652（95%CI，0.553-0.751）、0.776（95%CI，0.692-0.859）和 0.688（95%CI，0.606-0.770）。年龄、入院 GCS 评分、心率、气管切开术和血小板计数可作为严重 TBI 合并颅外创伤患者临床预后的独立预测指标。
