重大创伤中亲密伴侣暴力和其他与暴力相关的创伤性脑损伤的流行病学和 6 个月及 12 个月结局：一项基于人群的创伤登记研究。
Epidemiology and 6- and 12-Month Outcomes of Intimate Partner Violence and Other Violence-Related Traumatic Brain Injury in Major Trauma: A Population-Based Trauma Registry Study.
机构信息
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (Drs Gabbe, Braaf, and Cameron); Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, United Kingdom (Dr Gabbe); Emergency and Trauma Centre, The Alfred, Melbourne, Victoria Australia (Dr Cameron); and Victorian Injury Surveillance Unit, Monash University Accident Research Centre, Clayton, Victoria, Australia (Dr Berecki-Gisolf).
出版信息
J Head Trauma Rehabil. 2022;37(1):E1-E9. doi: 10.1097/HTR.0000000000000741.
OBJECTIVE
To compare the epidemiology, in-hospital outcomes, and 6-month and 12-month patient-reported, outcomes of major trauma patients with intimate partner violence (IPV)-related traumatic brain injury (TBI) with other interpersonal violence (OV)-related TBI.
SETTING
Victoria, Australia.
PARTICIPANTS
Adult (≥18 years) major trauma cases with TBI (concussion, skull fracture, or intracranial injury), injured through IPV or OV, between July 2010 and June 2020, and included on the population-based Victorian State Trauma Registry. There were 133 adult major trauma cases due to IPV and 1796 due to OV. The prevalence of TBI was 39% (n = 52) in the IPV group and 56% (n = 1010) in the OV group.
DESIGN
Registry-based cohort study.
MAIN MEASURES
Trauma care indicators and 6- and 12-month patient-reported outcomes (self-reported disability, Glasgow Outcome Scale-Extended, EQ-5D-3L, and return to work).
RESULTS
The annual incidence (95% CI) of major trauma involving TBI was 0.11 (0.08-0.14) per 100 000 population for IPV and 2.11 (1.98-2.24) per 100 000 for OV. A higher proportion of IPV-related cases were women (73% vs 5%), had sustained a severe TBI (Glasgow Coma Scale score 3-8; 27% vs 15%), were admitted to intensive care (56% vs 37%), and died in hospital (14% vs 5%). The median (interquartile range) time to definitive care (4.7 hours vs 3.3 hours) and head computed tomographic scan (5.0 hours vs 3.1 hours) was longer in the IPV group. Follow-up rates at 6 and 12 months were 71% and 69%, respectively. The 6- and 12-month outcomes were generally poorer in the IPV-related group.
CONCLUSION
The incidence of IPV-related major trauma with TBI was low. However, the prevalence of severe TBI, the time to key aspects of clinical care, in-hospital mortality, and longer-term work-related disability were higher. However, power to detect differences was low due to the small number of IPV-related cases compared with the OV group.
目的
比较与亲密伴侣暴力（IPV）相关创伤性脑损伤（TBI）和其他人际暴力（OV）相关 TBI 的主要创伤患者的流行病学、住院结局以及 6 个月和 12 个月的患者报告结局。
设置
澳大利亚维多利亚州。
参与者
2010 年 7 月至 2020 年 6 月期间，因 IPV 或 OV 受伤且人口统计学上存在 TBI（脑震荡、颅骨骨折或颅内损伤）的成年（≥18 岁）主要创伤病例，登记在基于人群的维多利亚州创伤登记处。共有 133 例因 IPV 导致的成人主要创伤病例和 1796 例因 OV 导致的成人主要创伤病例。在 IPV 组中，TBI 的患病率为 39%（n=52），在 OV 组中为 56%（n=1010）。
设计
基于登记的队列研究。
主要测量指标
创伤护理指标和 6 个月和 12 个月的患者报告结局（自我报告残疾、格拉斯哥结局扩展量表、EQ-5D-3L 和重返工作岗位）。
结果
IPV 导致的 TBI 涉及的主要创伤的年发生率（95%CI）为每 100000 人口 0.11（0.08-0.14），OV 为每 100000 人口 2.11（1.98-2.24）。更多的 IPV 相关病例为女性（73%比 5%），发生严重 TBI（格拉斯哥昏迷量表评分 3-8；27%比 15%），收入重症监护病房（56%比 37%），并在医院死亡（14%比 5%）。IPV 组中，确定性治疗（4.7 小时比 3.3 小时）和头部计算机断层扫描（5.0 小时比 3.1 小时）的中位（四分位距）时间更长。6 个月和 12 个月的随访率分别为 71%和 69%。IPV 相关组的 6 个月和 12 个月结局通常较差。
结论
与 IPV 相关的 TBI 主要创伤的发生率较低。然而，严重 TBI 的患病率、关键临床护理方面的时间、住院死亡率和长期与工作相关的残疾率更高。然而，与 OV 组相比，IPV 相关病例数量较少，因此检测差异的能力较低。
Zotero 插件