Yang Yongxiang, Peng Yuping, He Siyi, Wu Jianping, Xie Qingyun, Ma Yuan
Department of Neurosurgery, General Hospital of Western Theater Command, Chengdu, China.
Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Front Neurol. 2022 Apr 25;13:848944. doi: 10.3389/fneur.2022.848944. eCollection 2022.
Traumatic brain injury (TBI) is a leading cause of death and disability, which tends to have a worse clinical recovery if it occurs in plateau areas than in plain areas. To explore the underlying cause of this outcome preliminarily, this retrospective study was conducted to compare the clinical differences of patients with TBI in plateau and plain areas.
In this study, 32 patients with TBI in plateau areas (altitude ≥ 4,000 m) and 32 in plain areas (altitude ≤ 1,000 m) were recruited according to the inclusion and exclusion criteria from June 2020 to December 2021. The collected data and compared parameters include clinical features, head CT presentations and Marshall classifications, hematology profile, lipid profile, coagulation profile, and multiorgan (cardiac, liver, renal) function within 24 h of hospital admission, as well as the treatment method and final outcome.
There were no obvious differences in demographic characteristics, including gender, age, height, and weight, between patients with TBI in plateau and plain areas (all > 0.05). Compared to patients with TBI in plain areas, the time before hospital admission was longer, heartbeat was slower, systolic blood pressure (SBP) was lower, and hospital stays were longer in patients with TBI in plateau areas (all < 0.05). More importantly, elevated red blood cells (RBCs) count and hemoglobin (HGB) level, enhanced coagulation function, and higher rates of multiorgan (cardiac, liver, and renal) injury were found in patients with TBI in plateau areas (all < 0.05).
Patients with TBI in plateau areas presented with altered clinical characteristics, enhanced coagulation function, and aggravated predisposition toward multiorgan (cardiac, liver, and renal) injury, compared to patients with TBI in plain areas. Future prospective studies are needed to further elucidate the influences of high altitude on the disease course of TBI.
创伤性脑损伤（TBI）是死亡和残疾的主要原因之一，与平原地区相比，高原地区发生的TBI临床恢复往往更差。为初步探讨这一结果的潜在原因，本研究进行了一项回顾性研究，比较高原地区和平原地区TBI患者的临床差异。
本研究根据纳入和排除标准，于2020年6月至2021年12月招募了32例高原地区（海拔≥4000米）的TBI患者和32例平原地区（海拔≤1000米）的TBI患者。收集的数据和比较的参数包括临床特征、头颅CT表现和马歇尔分级、血液学指标、血脂指标、凝血指标以及入院24小时内的多器官（心脏、肝脏、肾脏）功能，以及治疗方法和最终结局。
高原地区和平原地区的TBI患者在人口统计学特征（包括性别、年龄、身高和体重）方面无明显差异（均>0.05）。与平原地区的TBI患者相比，高原地区的TBI患者入院前时间更长、心率更慢、收缩压（SBP）更低、住院时间更长（均<0.05）。更重要的是，高原地区的TBI患者红细胞（RBC）计数和血红蛋白（HGB）水平升高、凝血功能增强、多器官（心脏、肝脏和肾脏）损伤发生率更高（均<0.05）。
与平原地区的TBI患者相比，高原地区的TBI患者临床特征改变、凝血功能增强、多器官（心脏、肝脏和肾脏）损伤倾向加重。未来需要进行前瞻性研究，以进一步阐明高海拔对TBI病程的影响。
