Sedlák Marián, Wazir Adonis, Dima Aikaterini, Gazda Jakub, Morochovič Radoslav
Trauma Surgery Department, Pavol Jozef Safarik University in Kosice, Faculty of Medicine & Louis Pasteur University Hospital, Kosice, Slovakia.
Zachranna Sluzba Kosice, Kosice, Slovakia.
Open Access Emerg Med. 2023 Jul 25;15:265-275. doi: 10.2147/OAEM.S422785. eCollection 2023.
Traumatic brain injury (TBI) is one of the most common trauma-related diagnoses among the elderly population treated in emergency departments (ED). Identification of patients with increased or decreased risk of intracranial bleeding is of clinical importance. The objective of this study was to evaluate the implication of cutaneous impact location (CIL) on the prevalence of intracranial injury after suspected or confirmed TBI irrespective of its severity.
This was a retrospective, single-center, descriptive observational study of geriatric patients aged 65 years and older treated for suspected or confirmed TBI in a trauma surgery ED. The primary outcome of the study was the assessment of a CIL of the injury and its association with the prevalence of intracranial lesions found on a head computed tomography scan.
Among 381 patients included in the analysis, the CIL of interest (temporo-parietal and occipital impacts) was present among 178 (46.7%) cases. Thirty-six (9.5%) patients were diagnosed with intracranial bleeding. The prevalence of intracranial bleeding was higher in the CIL of interest group compared with other locations outside (12.9% vs 6.4%; p = 0.030). CIL of interest was a predictor of intracranial bleeding (p = 0.033; OR: 2.17; 95% CI: 1.06 to 4.42).
The CIL of head injury is a predictor of intracranial lesions among geriatric patients with traumatic brain injury. Physicians should be aware of this association when assessing elderly patients with head injuries. More studies are needed to develop a clinical management tool incorporating CIL to guide the diagnosis of TBI in this population.
创伤性脑损伤（TBI）是急诊科治疗的老年人群中最常见的创伤相关诊断之一。识别颅内出血风险增加或降低的患者具有临床重要性。本研究的目的是评估皮肤撞击部位（CIL）对疑似或确诊TBI后颅内损伤患病率的影响，无论其严重程度如何。
这是一项对在创伤外科急诊科接受疑似或确诊TBI治疗的65岁及以上老年患者进行的回顾性、单中心、描述性观察研究。该研究的主要结果是评估损伤的CIL及其与头部计算机断层扫描上发现的颅内病变患病率的关联。
在纳入分析的381例患者中，178例（46.7%）存在感兴趣的CIL（颞顶叶和枕部撞击）。36例（9.5%）患者被诊断为颅内出血。与其他部位相比，感兴趣的CIL组颅内出血的患病率更高（12.9%对6.4%；p=0.030）。感兴趣的CIL是颅内出血的一个预测因素（p=0.033；OR：2.17；95%CI：1.06至4.42）。
头部损伤的CIL是老年创伤性脑损伤患者颅内病变的一个预测因素。医生在评估老年头部受伤患者时应意识到这种关联。需要更多的研究来开发一种纳入CIL的临床管理工具，以指导该人群中TBI的诊断。
