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创伤性脑损伤后精神障碍的危险因素:多变量逻辑回归分析

Risk factors for psychiatric disorders following traumatic brain injury: a multivariate logistic regression analysis.

作者信息

Liu Hanyu, Yi Tongjun

机构信息

Huludao Central Hospital, Huludao, Liaoning, China.

出版信息

Front Psychiatry. 2024 Nov 27;15:1499894. doi: 10.3389/fpsyt.2024.1499894. eCollection 2024.

Abstract

OBJECTIVE

This study aimed to investigate the incidence and risk factors of psychiatric disorders following traumatic brain injury (TBI).

METHODS

A total of 232 patients with closed TBI admitted to our hospital from January 2021 to January 2023 were included. Basic demographic data, injury circumstances, and psychiatric conditions during hospitalization were collected. Patients were followed up at 9 months post-injury, and based on clinical interviews, symptoms, and questionnaires, they were categorized into those with post-TBI psychiatric disorders and those without. The study aimed to explore the predictive factors for psychiatric disorders after TBI.

RESULTS

Among the 232 patients, 104 developed psychiatric disorders by the end of the 9-month follow-up, resulting in an incidence rate of 44.83%. The employment rate was significantly lower in the psychiatric disorder group compared to the non-psychiatric disorder group. Additionally, the GCS scores upon admission were significantly higher in the psychiatric disorder group, along with a greater proportion of limb injuries, post-traumatic coma, intracranial hematomas, and frontal lobe injuries. The results of the multivariate logistic regression analysis indicated that unemployment (caused by poor recovery from TBI), lower GCS scores at admission, limb injuries, post-traumatic coma, frontal lobe injuries, and the presence of psychiatric symptoms during hospitalization were independent predictors of psychiatric disorders following TBI.

CONCLUSION

Unemployment, lower GCS score on admission, limb injury, post-traumatic coma, frontal lobe injury, onset of psychiatric symptoms during hospitalization was identified as independent predictors of post-traumatic psychiatric disorders. Routine mental health screenings for conditions such as depression and anxiety should be integrated into the care of TBI patients.

摘要

目的

本研究旨在调查创伤性脑损伤(TBI)后精神障碍的发病率及危险因素。

方法

纳入2021年1月至2023年1月期间我院收治的232例闭合性TBI患者。收集基本人口统计学数据、受伤情况及住院期间的精神状况。在受伤后9个月对患者进行随访,根据临床访谈、症状及问卷调查,将患者分为TBI后精神障碍患者和无精神障碍患者。本研究旨在探索TBI后精神障碍的预测因素。

结果

在232例患者中,104例在9个月随访结束时出现精神障碍,发病率为44.83%。精神障碍组的就业率显著低于非精神障碍组。此外,精神障碍组入院时的格拉斯哥昏迷量表(GCS)评分显著更高,肢体损伤、创伤后昏迷、颅内血肿及额叶损伤的比例也更高。多因素logistic回归分析结果表明,失业(因TBI恢复不佳导致)、入院时较低的GCS评分、肢体损伤、创伤后昏迷、额叶损伤及住院期间出现精神症状是TBI后精神障碍的独立预测因素。

结论

失业、入院时较低的GCS评分、肢体损伤、创伤后昏迷、额叶损伤、住院期间出现精神症状被确定为创伤后精神障碍的独立预测因素。应将抑郁症和焦虑症等常规心理健康筛查纳入TBI患者的护理中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4a0/11631929/75963528c2de/fpsyt-15-1499894-g001.jpg

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