Magnusson Beatrice M, Koskinen Lars-Owe D
Department of Surgery and Perioperative Sciences, Anaesthesiology and Intensive Care Medicine, Umeå University, 901 87 Umeå, Sweden.
Department of Clinical Science, Neurosciences, Umeå University, 901 87 Umeå, Sweden.
J Clin Med. 2023 Dec 19;13(1):8. doi: 10.3390/jcm13010008.
Traumatic brain injury (TBI) is a common cause of death and disability, the incidence of which in northern Sweden is not fully investigated. This study classifies and characterize epidemiological and demographic features of TBIs in a defined population in Umeå county, Sweden. Specifically, to evaluate frequencies of (1) intracranial lesions detected with computed tomography (CT), (2) need for emergency intervention, and (3) hospital admission, in minimal, mild, moderate, and severe TBI, respectively.
The data were gathered from 4057 TBI patients visiting our emergency room (ER) during a two-year period (2015-2016), of whom 56% were men and approximately 95% had minimal TBIs (Glasgow Coma Scale (GCS), score 15).
Of all injuries, 97.8% were mild (GCS 14-15), 1.7% were moderate (GCS 9-13), and 0.5% were severe (GCS < 9). CT scans were performed on 46% of the patients, with 28% being hospitalized. A high annual TBI incidence of 1350 cases per 100,000 citizens was found. The mortality rate was 0.5% with the majority as expected in the elderly group (>80 years).
Minimal TBIs were not as mild as previously reported, with a relatively high frequency of abnormal CT findings and a high mortality rate. No emergency intervention was required in patients in the GCS 13-15 group with normal CT scans. These findings have implications for clinical practice in the ER with the suggestion to include biomarkers to reduce unnecessary CT scans.
创伤性脑损伤（TBI）是死亡和残疾的常见原因，瑞典北部该损伤的发病率尚未得到充分研究。本研究对瑞典于默奥县特定人群中创伤性脑损伤的流行病学和人口统计学特征进行分类和描述。具体而言，分别评估在轻度、中度和重度创伤性脑损伤中，（1）通过计算机断层扫描（CT）检测到的颅内病变频率，（2）紧急干预需求，以及（3）住院情况。
数据收集自2015年至2016年两年间就诊于我们急诊室（ER）的4057例创伤性脑损伤患者，其中56%为男性，约95%为轻度创伤性脑损伤（格拉斯哥昏迷量表（GCS）评分为15分）。
在所有损伤中，97.8%为轻度（GCS 14 - 15），1.7%为中度（GCS 9 - 13），0.5%为重度（GCS < 9）。46%的患者进行了CT扫描，28%的患者住院治疗。发现每年创伤性脑损伤的发病率高达每10万公民1350例。死亡率为0.5%，如预期的那样，大多数死亡发生在老年组（>80岁）。
轻度创伤性脑损伤并不像先前报道的那么轻微，CT异常发现的频率相对较高，死亡率也较高。CT扫描正常的GCS 13 - 15组患者无需紧急干预。这些发现对急诊室的临床实践具有启示意义，建议纳入生物标志物以减少不必要的CT扫描。
