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急诊轻度创伤性脑损伤就诊:与老年年龄、性别和跌倒损伤的关联。

Emergency Department Visits for Mild Traumatic Brain Injury: Associations with Geriatric Age, Sex, and Fall Injury.

机构信息

Dep. of Physical Therapy, Western Michigan University, 1903 W. Michigan Ave., Kalamazoo, MI 49009, USA. Tel 269-387-8369.

出版信息

J Allied Health. 2024 Summer;53(2):155-160.

Abstract

PURPOSE

The highest rates mTBI occurrence are seen among geriatric populations (ages ≥65), and these patients often have persistent and untreated symptoms. This study's purpose was to explore mild traumatic brain injury initial onset (mTBI-IN) and mild traumatic brain injury subsequent (mTBI-S) emergency department (ED) visit population percentages and associations with geriatric (population ages ≥65), sex, and fall mechanism of injury.

METHODS

The design was a population-based cross-sectional study using data from the 2018 Nationwide Emergency Department Sample (NEDS). Study sample size was 261,349. An independent t-test was used to investigate mean age differences between mTBI-IN and mTBI-S. Pearson's chi-squared correlational analyses were used to investigate associations of age, sex, and fall injury with mTBI-IN and mTBI-S.

RESULTS

The mean age of those in 2018 with ED visits suggested that age was older for those patients with mTBI-S (age mean, 50.4 yrs) than those with mTBI-IN (age mean, 41.4 yrs) (95% CI 9.77, 8.30; p=0.025). The number of visits for those aged ≥65 was significantly associated with mTBI-S (p<0.001). More males than females reported mTBI-S ED visits in all ages (p=0.022). Falls injury alone was not found to be significantly associated with visits (p<0.001).

CONCLUSIONS

Those returning to the ED for continued care after mTBI were associated with those aged ≥65. Monitoring after mTBI ED visits may need to target geriatric populations for medical management.

摘要

目的

最高的 mTBI 发生率见于老年人群体(年龄≥65 岁),这些患者往往存在持续且未经治疗的症状。本研究的目的是探讨轻度创伤性脑损伤初始发作(mTBI-IN)和轻度创伤性脑损伤后续发作(mTBI-S)急诊科(ED)就诊人群的比例,以及与老年(年龄≥65 岁)、性别和跌倒损伤机制的关联。

方法

本研究设计采用 2018 年全国急诊抽样调查(NEDS)的数据进行了一项基于人群的横断面研究。研究样本量为 261349 例。采用独立 t 检验比较 mTBI-IN 和 mTBI-S 组之间的平均年龄差异。采用 Pearson 卡方相关性分析研究年龄、性别和跌倒损伤与 mTBI-IN 和 mTBI-S 的相关性。

结果

2018 年 ED 就诊患者的平均年龄表明,mTBI-S 患者(平均年龄 50.4 岁)比 mTBI-IN 患者(平均年龄 41.4 岁)年龄更大(95%CI 9.77,8.30;p=0.025)。≥65 岁患者就诊次数与 mTBI-S 显著相关(p<0.001)。所有年龄段中,报告 mTBI-S ED 就诊的男性多于女性(p=0.022)。单独的跌倒损伤与就诊无显著相关性(p<0.001)。

结论

那些因 mTBI 后需要继续治疗而返回 ED 的患者与≥65 岁的患者相关。mTBI ED 就诊后可能需要针对老年人群进行医疗管理。

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