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成人患者在阿姆哈拉州地区综合专科医院接受治疗的创伤性脑损伤的结果和相关因素。

Outcomes and associated factors of traumatic brain injury among adult patients treated in Amhara regional state comprehensive specialized hospitals.

机构信息

Department of Surgical Nursing, School of Nursing, College of Health Sciences, Aksum University, Aksum, Ethiopia.

Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Emerg Med. 2023 Sep 19;23(1):109. doi: 10.1186/s12873-023-00859-x.

Abstract

BACKGROUND

Globally, traumatic brain injury is the leading cause of death and disability which affects more than 69 million individuals a year.

OBJECTIVE

This study aimed to assess the outcome and associated factors of traumatic brain injury among adult patients treated in Amhara regional state comprehensive specialized hospitals.

METHOD

Institutional-based cross-sectional study design was conducted from January 1, 2018, to December 30, 2020. A simple random sampling technique was used and a checklist was used to extract data between March 15 and April 15, 2021. The data were entered into Epi-data version 4.2 and exported to SPSS version 25 for analysis after being checked for consistency. Associated variables with outcomes of traumatic brain injury were determined by a binary logistic regression model. The degree of association was interpreted by using AOR and a 95% confidence interval with a p-value less than or equal to 0.05 at 95% CI was considered statistically significant.

RESULT

In this study road traffic injury was the most frequent cause of traumatic brain injuries among adult patients, accounting for 181 (37.5%), followed by assault, accounting for 117 (24.2%) which affects adult age groups. One-third of the participant had a moderate Glasgow coma scale of 174(36%). Only 128(26.8%) patients arrived within one hour. One hundred sixty, 160 (33.1%) of patients had a mild traumatic brain injury, whereas, 149(36%) of patients had a severe traumatic brain injury. Regarding computerized tomography scans findings, the hematoma was the most common (n = 163, 33.7%). Ninety-one, 91(18.8%) of participants had cerebrospinal fluid otorrhea, and, 92(19%) were diagnosed with a positive battle sign. The overall prevalence of unfavorable outcomes after traumatic brain injury was found to be 35.2% (95%CI (30.8-39.1). Having additional Injury, hypoxia, time to hospital presentation after 24 h, severe Glasgow Coma Scale, moderate Glasgow Coma Scale, tachypnea, bradypnea, and cerebrospinal fluid Othorrhea, were factors associated with unfavorable outcomes.

CONCLUSION AND RECOMMENDATION

In this study, the overall unfavorable outcome was experienced by about four out of every 10 victims of traumatic brain injury. Time of arrival > 24 h, low Glasgow coma scale, additional injury, Cerebrospinal fluid otorrhea, abnormal respiration, and hypoxia were significant predictors of unfavorable outcomes. To reduce the adverse effects of traumatic brain injury in adults, it is therefore desirable to guarantee safe road traffic flow and improve health care services.

摘要

背景

在全球范围内,创伤性脑损伤是导致死亡和残疾的主要原因,每年影响超过 6900 万人。

目的

本研究旨在评估在阿姆哈拉地区综合专科医院接受治疗的成年创伤性脑损伤患者的结局和相关因素。

方法

本研究采用了 2018 年 1 月 1 日至 2020 年 12 月 30 日期间的基于机构的横断面研究设计。采用简单随机抽样技术,于 2021 年 3 月 15 日至 4 月 15 日期间使用检查表提取数据。数据在经过一致性检查后,输入 Epi-data 版本 4.2 并导出到 SPSS 版本 25 进行分析。使用二元逻辑回归模型确定与创伤性脑损伤结局相关的变量。使用比值比(AOR)和 95%置信区间来解释关联程度,置信区间为 95%,p 值小于或等于 0.05 被认为具有统计学意义。

结果

在这项研究中,道路交通伤害是成年创伤性脑损伤患者最常见的原因,占 181 例(37.5%),其次是袭击,占 117 例(24.2%),影响成年年龄组。三分之一的参与者格拉斯哥昏迷量表得分为 174(36%)。只有 128 例(26.8%)患者在 1 小时内到达。160 例(33.1%)患者有轻度创伤性脑损伤,而 149 例(36%)患者有严重创伤性脑损伤。根据计算机断层扫描结果,血肿是最常见的(n=163,33.7%)。91 例(18.8%)参与者有脑脊液耳漏,92 例(19%)有阳性战斗征。创伤性脑损伤后不良结局的总体发生率为 35.2%(95%CI(30.8-39.1))。有额外损伤、缺氧、24 小时后到医院就诊时间、严重格拉斯哥昏迷量表评分、中度格拉斯哥昏迷量表评分、呼吸过速、呼吸过缓、脑脊液耳漏,是与不良结局相关的因素。

结论和建议

在这项研究中,约每 10 名创伤性脑损伤患者中就有 4 人经历了总体不良结局。到达时间>24 小时、格拉斯哥昏迷量表评分低、额外损伤、脑脊液耳漏、异常呼吸和缺氧是不良结局的显著预测因素。为了降低成年人创伤性脑损伤的不良影响,因此需要保证道路交通安全并改善医疗服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a32/10510140/953357e09e6b/12873_2023_859_Fig1_HTML.jpg

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