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澳大利亚 2015-20 年中度至重度创伤性脑损伤后的住院和院内死亡:澳大利亚创伤性脑损伤国家数据 (ATBIND) 项目的登记数据分析。

Hospitalisations and in-hospital deaths following moderate to severe traumatic brain injury in Australia, 2015-20: a registry data analysis for the Australian Traumatic Brain Injury National Data (ATBIND) project.

机构信息

Alfred Hospital, Melbourne, VIC.

National Trauma Research Institute, Alfred Hospital, Melbourne, VIC.

出版信息

Med J Aust. 2023 Oct 2;219(7):316-324. doi: 10.5694/mja2.52055. Epub 2023 Jul 31.

Abstract

OBJECTIVE

To describe the frequency of hospitalisation and in-hospital death following moderate to severe traumatic brain injury (TBI) in Australia, both overall and by patient demographic characteristics and the nature and severity of the injury.

DESIGN, SETTING: Cross-sectional study; analysis of Australia New Zealand Trauma Registry data.

PARTICIPANTS

People with moderate to severe TBI (Abbreviated Injury Score [head] greater than 2) who were admitted to or died in one of the twenty-three major Australian trauma services that contributed data to the ATR throughout the study period, 1 July 2015 - 30 June 2020.

MAJOR OUTCOME MEASURES

Primary outcome: number of hospitalisations with moderate to severe TBI; secondary outcome: number of deaths in hospital following moderate to severe TBI.

RESULTS

During 2015-20, 16 350 people were hospitalised with moderate to severe TBI (mean, 3270 per year), of whom 2437 died in hospital (14.9%; mean, 487 per year). The mean age at admission was 50.5 years (standard deviation [SD], 26.1 years), and 11 644 patients were male (71.2%); the mean age of people who died in hospital was 60.4 years (SD, 25.2 years), and 1686 deaths were of male patients (69.2%). The overall number of hospitalisations did not change during 2015-20 (per year: incidence rate ratio [IRR], 1.00; 95% confidence interval [CI], 0.99-1.02) and death (IRR, 1.00; 95% CI, 0.97-1.03).

CONCLUSION

Injury prevention and trauma care interventions for people with moderate to severe TBI in Australia reduced neither the incidence of the condition nor the associated in-hospital mortality during 2015-20. More effective care strategies are required to reduce the burden of TBI, particularly among younger men.

摘要

目的

描述澳大利亚中度至重度创伤性脑损伤(TBI)患者的住院和院内死亡频率,包括总体情况以及根据患者人口统计学特征、损伤性质和严重程度进行的情况。

设计、设置:横断面研究;对澳大利亚新西兰创伤登记处数据进行分析。

参与者

在整个研究期间,2015 年 7 月 1 日至 2020 年 6 月 30 日,有 23 家主要澳大利亚创伤服务机构中符合纳入条件的中度至重度 TBI(头部损伤严重程度评分[头部]大于 2)患者入院或死亡。

主要观察指标

主要结局:中度至重度 TBI 患者的住院次数;次要结局:中度至重度 TBI 患者住院后的死亡人数。

结果

2015-20 年间,有 16350 人因中度至重度 TBI 住院(平均每年 3270 人),其中 2437 人在医院死亡(14.9%;平均每年 487 人)。入院时的平均年龄为 50.5 岁(标准差[SD],26.1 岁),11644 名患者为男性(71.2%);在医院死亡的人的平均年龄为 60.4 岁(SD,25.2 岁),其中 1686 人是男性(69.2%)。2015-20 年期间,住院总人数没有变化(每年:发病率比[IRR],1.00;95%置信区间[CI],0.99-1.02)和死亡(IRR,1.00;95%CI,0.97-1.03)。

结论

在澳大利亚,针对中度至重度 TBI 患者的伤害预防和创伤护理干预措施,在 2015-20 年期间,既没有降低该疾病的发病率,也没有降低相关的院内死亡率。需要更有效的护理策略来降低 TBI 的负担,特别是在年轻男性中。

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