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创伤性颅脑损伤患者的并发脊柱创伤:一项七年回顾性分析。

Concurrent Spinal Trauma in Patients with Traumatic Head Injury: A Seven-Year Retrospective Analysis.

机构信息

Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland).

出版信息

Med Sci Monit. 2023 Aug 19;29:e939215. doi: 10.12659/MSM.939215.

DOI:10.12659/MSM.939215
PMID:37596775
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10445503/
Abstract

BACKGROUND Assessing spinal injuries in patients with traumatic head injuries is crucial due to their potential to alter functionality and increase mortality rates. This single-center retrospective study was conducted to understand the prevalence and characteristics of concurrent spinal injuries in adults with traumatic head injury from April 2015 to April 2022. MATERIAL AND METHODS The study incorporated demographic, clinical, traumatological, and hemodynamic data from 1,501 adult patients presenting with traumatic head injuries. Spinal injuries were identified through symptoms, physical signs, and radiological findings. RESULTS During the study period, 179 patients (12%) were reported with associated spinal injuries. These patients were predominantly male (p=0.0012), aged 65 years or above (p=0.0452), had thoracic injuries (p=0.0004), and arrived at the emergency department more than three hours post-trauma (p=0.0004). Most injuries were caused by motor vehicle accidents (p=0.0412) or falls from heights greater than 3 meters (p=0.0481). In addition, these patients had higher Abbreviated Injury Scale scores (≥2, p=0.0391), Eppendorf-Cologne Scale scores (≥2, p=0.0412), and lower systolic and diastolic blood pressure readings (p=0.0481, p=0.0412) along with lower heart rates (p=0.0482). However, no correlation was found between systolic and diastolic pressures and age among patients with spinal injuries. CONCLUSIONS This study reveals that the prevalence and severity of spinal injuries in patients with traumatic head injuries are influenced not only by demographic and clinical parameters, but also by the degree and extent of head trauma.

摘要

背景

由于可能改变功能并增加死亡率,评估创伤性颅脑损伤患者的脊柱损伤至关重要。本单中心回顾性研究旨在了解 2015 年 4 月至 2022 年 4 月期间外伤性颅脑损伤成人中并发脊柱损伤的发生率和特征。

材料和方法

研究纳入了 1501 例创伤性颅脑损伤成年患者的人口统计学、临床、创伤学和血流动力学数据。通过症状、体格检查和影像学发现确定脊柱损伤。

结果

研究期间,179 例(12%)患者报告存在相关脊柱损伤。这些患者主要为男性(p=0.0012)、年龄 65 岁或以上(p=0.0452)、有胸伤(p=0.0004)和创伤后 3 小时以上到达急诊室(p=0.0004)。大多数损伤是由机动车事故(p=0.0412)或 3 米以上高处坠落引起的(p=0.0481)。此外,这些患者的损伤严重程度评分(Abbreviated Injury Scale,AIS≥2,p=0.0391)、Eppendorf-Cologne 评分(≥2,p=0.0412)较高,收缩压和舒张压读数较低(p=0.0481,p=0.0412),心率较低(p=0.0482)。然而,在脊柱损伤患者中,收缩压和舒张压与年龄之间没有相关性。

结论

本研究表明,创伤性颅脑损伤患者脊柱损伤的发生率和严重程度不仅受人口统计学和临床参数的影响,还受头部创伤的程度和范围的影响。

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本文引用的文献

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[Levels and trends of significant injury-caused deaths in the Chinese population, 2010-2019].[2010 - 2019年中国人群重大伤害致死水平及趋势]
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Trends and external causes of traumatic brain injury and spinal cord injury mortality in south China, 2014-2018: an ecological study.
中国南方地区 2014-2018 年创伤性脑损伤和脊髓损伤死亡率的趋势及外部原因:一项生态学研究。
BMC Public Health. 2021 Dec 7;21(1):2225. doi: 10.1186/s12889-021-12225-2.
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Evaluation and Management of Cauda Equina Syndrome.马尾综合征的评估与管理
Am J Med. 2021 Dec;134(12):1483-1489. doi: 10.1016/j.amjmed.2021.07.021. Epub 2021 Aug 30.
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Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures.严重创伤患者创伤性脊柱损伤的流行病学和预测因素:对急诊程序的影响。
Eur J Trauma Emerg Surg. 2022 Jun;48(3):1975-1983. doi: 10.1007/s00068-020-01515-w. Epub 2020 Oct 6.
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Epidemiological features of traumatic spinal cord injury in Beijing, China.中国北京外伤性脊髓损伤的流行病学特征。
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