Li Cheng-Yu, Chuang Chi-Cheng, Chen Ching-Chang, Tu Po-Hsun, Wang Yu-Chi, Yeap Mun-Chun, Chen Chun-Ting, Chang Ting-Wei, Liu Zhuo-Hao
Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan 333, Taiwan.
J Clin Med. 2022 Apr 11;11(8):2127. doi: 10.3390/jcm11082127.
Traumatic intraventricular hemorrhage (tIVH) is associated with increased mortality and disability in traumatic brain injury (TBI). However, the significance of tIVH itself remains unclear. Our goal is to assess whether tIVH affects in-hospital mortality and short-term functional outcomes. We retrospectively reviewed the records of 5048 patients with TBI during a 5-year period, and 149 tIVH patients were analyzed. Confounding was reduced using the inverse probability of treatment weighting (IPTW) based on propensity score. The association between IVH and outcomes was investigated using logistic regression in the IPTW-adjusted cohort. In our study, after adjustment for analysis, the in-hospital mortality rate (11.4% vs. 9.2%) and the poor functional outcome rate (37.9% vs.10.6%) were significantly higher in the tIVH group than in the non-tIVH group. Factors independently associated with outcomes were age ≥ 65 years, Glasgow Coma Scale (GCS) severity score, and the Graeb score. The Traumatic Graeb Score, a novel scoring system for predicting functional outcomes associated with tIVH, comprised the sum of the following components: GCS scores of 3 to 4 (=2 points), 5 to 12 (=1 point), 13 to 15 (=0 points); age ≥ 65 years, yes (=1 point), no (=0 points); Graeb score (0-12 points). A Traumatic Graeb Score ≥ 4 is an optimal cutoff value for poor short-term functional outcomes.
创伤性脑室内出血（tIVH）与创伤性脑损伤（TBI）患者死亡率和残疾率的增加相关。然而，tIVH本身的意义仍不明确。我们的目标是评估tIVH是否会影响住院死亡率和短期功能结局。我们回顾性分析了5年期间5048例TBI患者的记录，并对149例tIVH患者进行了分析。使用基于倾向评分的治疗权重逆概率（IPTW）来减少混杂因素。在IPTW校正队列中，采用逻辑回归研究IVH与结局之间的关联。在我们的研究中，经过分析调整后，tIVH组的住院死亡率（11.4%对9.2%）和不良功能结局率（37.9%对10.6%）显著高于非tIVH组。与结局独立相关的因素包括年龄≥65岁、格拉斯哥昏迷量表（GCS）严重程度评分和格雷布评分。创伤性格雷布评分是一种用于预测与tIVH相关的功能结局的新型评分系统，由以下成分的总和组成：GCS评分为3至4（=2分）、5至12（=1分）、13至15（=0分）；年龄≥65岁，是（=1分），否（=0分）；格雷布评分（0 - 12分）。创伤性格雷布评分≥4是短期功能结局不良的最佳临界值。
