Ito Hiroshi, Nakamura Youhei, Togami Yuki, Onishi Shinya, Nakao Shunichiro, Ogura Hiroshi, Oda Jun
Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine Suita Osaka Japan.
Acute Med Surg. 2024 Feb 20;11(1):e931. doi: 10.1002/ams2.931. eCollection 2024 Jan-Dec.
This study investigated whether contrast extravasation on computed tomography (CT) angiography in patients with traumatic brain injury (TBI) is associated with death or surgical procedures.
Patients over 18 years old, directly brought in by ambulance with an isolated head injury and confirmed to have acute intracranial hemorrhage on a CT scan upon admission between 2010 and 2020, were included. The primary outcome was mortality, and the secondary outcome was neurosurgical procedures performed from admission to discharge from the intensive care unit. Multivariable logistic regression analyses were performed to evaluate the association between these outcomes and contrast extravasation.
The analysis included 188 patients with a median age of 65 years, 123 men (65.4%), 34 deaths (18.1%), and 91 surgeries (48.4%). Among the 66 patients with contrast extravasation, 22 (33.3%) died and 47 (71.2%) required surgery. Among the 122 patients with no contrast extravasation, 12 (9.8%) died, and 44 (36.1%) required surgery. The presence or absence of extravascular leakage was associated with death (odds ratio, 3.6 [95% CI: 1.2-12.2]) and surgery (odds ratio, 7.6 [95% CI: 2.5-22.7]).
Contrast extravasation was associated with mortality and performance of surgery in patients with an isolated head injury.
本研究调查了创伤性脑损伤（TBI）患者在计算机断层扫描（CT）血管造影上的对比剂外渗是否与死亡或手术相关。
纳入2010年至2020年间年龄在18岁以上、由救护车直接送来且头部有孤立性损伤、入院时CT扫描确诊有急性颅内出血的患者。主要结局是死亡率，次要结局是从入院到重症监护病房出院期间进行的神经外科手术。进行多变量逻辑回归分析以评估这些结局与对比剂外渗之间的关联。
分析纳入了188例患者，中位年龄为65岁，男性123例（65.4%），死亡34例（18.1%），手术91例（48.4%）。在66例有对比剂外渗的患者中，22例（33.3%）死亡，47例（71.2%）需要手术。在122例无对比剂外渗的患者中，12例（9.8%）死亡，44例（36.1%）需要手术。血管外渗漏的有无与死亡（比值比，3.6 [95%可信区间：1.2 - 12.2]）和手术（比值比，7.6 [95%可信区间：2.5 - 22.7]）相关。
对比剂外渗与孤立性头部损伤患者的死亡率和手术情况相关。
