埃塞俄比亚东阿姆哈拉综合专科医院创伤性脑损伤患者的死亡时间及其预测因素：回顾性队列研究。

Time to death and its predictors among traumatic brain injury patients admitted to East Amhara comprehensive specialized hospitals, Ethiopia: retrospective cohort study.

机构信息

Department of Comprehensive Nursing, School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.

Department of Adult Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

出版信息

BMC Neurol. 2024 Oct 4;24(1):370. doi: 10.1186/s12883-024-03886-8.

DOI:10.1186/s12883-024-03886-8

PMID:39367316

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11451167/

Abstract

BACKGROUND

Globally, 64-74 million individuals around the world are estimated to sustain traumatic brain injury every year. Moderate and severe traumatic brain injury can lead to a lifetime physical, cognitive, emotional, and behavioral changes. There were limited studies conducted in Ethiopia regarding to traumatic brain injury mortality.

METHODS

An institutional based retrospective cohort study was conducted on 429 randomly selected traumatic brain injury patients aged 18 to 64 years who were admitted to East Amhara Comprehensive Specialized Hospitals from January 1, 2016 to December 31, 2021. Kobo toolbox was applied for data collection and exported to Stata version 17 for data processing and analysis. To estimate death free time, a Kaplan Meier failure curve was used. The Cox proportional hazards regression model was used at the 5% level of significance to determine effect of predictor variables on time to death.

RESULT

A total of 429 traumatic brain injury patients aged 18 to 64 years were included with response rate of 91.3% and 145(33.8%) were dead. Open injuries (AHR = 0.25; 95% CI: 0.18-0.36), co-existing injuries (AHR = 0.40; 95% CI: 0.24-0.66), ICU admission (AHR = 0.42; 95% CI: 0.29-0.60), arrival within 4-24 h (AHR = 3.48; 95% CI: 2.01-6.03), arrival after 24 h (AHR = 6.69; 95% CI: 3.49-12.28), subdural hematoma (AHR = 2.72; 95% CI: 1.77-4.19), serum albumin < 3.5 g/dL (AHR = 0.66; 95% CI: 0.49-0.94), moderate (AHR = 0.56; 95% CI: 0.21-0.89), and mild traumatic brain injury (AHR = 0.43; 95% CI: 0.29-0.56) were predictors of traumatic brain injury mortality.

CONCLUSION

The finding of this study showed that the mortality was 1/3rd of the total patients. Open injuries, co-existing injuries, ICU admission, arrival time (4-24 h and > 24 h), subdural hematoma, serum albumin < 3.5 g/dL and severity of traumatic brain injury (mild and moderate) were predictors of traumatic brain mortality. Therefore, working on these factors to reduce the morality of traumatic brain injury patients is very important.

摘要

背景

全球每年约有 6400 万至 7400 万人遭受创伤性脑损伤。中度和重度创伤性脑损伤可导致终生的身体、认知、情感和行为变化。埃塞俄比亚在创伤性脑损伤死亡率方面的研究有限。

方法

这是一项在东阿姆哈拉综合专科医院进行的基于机构的回顾性队列研究，纳入了 2016 年 1 月 1 日至 2021 年 12 月 31 日期间年龄在 18 至 64 岁的 429 名随机选择的创伤性脑损伤患者。Kobo 工具包用于数据收集，并导出到 Stata 17 进行数据处理和分析。为了估计无死亡时间，使用 Kaplan-Meier 失败曲线。使用 Cox 比例风险回归模型在 5%的显著性水平上确定预测变量对死亡时间的影响。

结果

共纳入 429 名 18 至 64 岁的创伤性脑损伤患者，应答率为 91.3%，145 人（33.8%）死亡。开放性损伤（AHR=0.25；95%CI：0.18-0.36）、合并损伤（AHR=0.40；95%CI：0.24-0.66）、重症监护病房入院（AHR=0.42；95%CI：0.29-0.60）、4-24 小时内到达（AHR=3.48；95%CI：2.01-6.03）、24 小时后到达（AHR=6.69；95%CI：3.49-12.28）、硬膜下血肿（AHR=2.72；95%CI：1.77-4.19）、血清白蛋白<3.5g/dL（AHR=0.66；95%CI：0.49-0.94）、中度（AHR=0.56；95%CI：0.21-0.89）和轻度创伤性脑损伤（AHR=0.43；95%CI：0.29-0.56）是创伤性脑损伤死亡率的预测因素。