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使用简明损伤定级标准和损伤严重度评分评估创伤性脑损伤严重程度:在两个东欧中心开展的一项回顾性研究

Evaluation of Traumatic Brain Injury Severity Using the Abbreviated Injury Scale and the Injury Severity Score: A Retrospective Study in Two Eastern European Centers.

作者信息

Vadan Iulia-Maria, Grad Diana, Strilciuc Stefan, Blesneag Alina Vasilica, Michalak Marcin, Vacaras Vitalie, Stan Adina, Muresanu Dafin F

机构信息

Department of Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania.

RoNeuro Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania.

出版信息

J Clin Med. 2025 Sep 4;14(17):6259. doi: 10.3390/jcm14176259.

Abstract

: Traumatic brain injury (TBI) is a significant global public health issue, with long-term impacts on patients. This study examines the relationship between TBI severity, as measured by the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) at admission, and various sociodemographic, clinical, and injury-related factors. : We conducted a retrospective analysis using data from 164 adult TBI patients. All were admitted between March 2020 and June 2023 to two Eastern European tertiary hospitals. Variables included sex, age, education, employment, marital status, injury type and cause, place of injury, and clinical measures such as the Marshall score, AIS, and ISS. Statistical methods included Pearson's Chi-squared, Fisher's exact, Spearman correlation, Wilcoxon, and Kruskal-Wallis tests. : Most patients were male (65.9%), retired (59.8%), and urban residents (73.8%), with a mean age of 64.98 years. The most frequent mechanism of injury was falls (76.2%), typically occurring at home (61%). The predominant injury type was closed head trauma (93.3%). Most patients had mild AIS scores (75%), and the mean ISS was 6.52 (SD: 4.55). Statistically significant group differences were found for AIS among categories of Modified Marshall Score, injury type, and education categories and for ISS among categories of the Modified Marshall Score, injury type, cause and place of injury, employment status, and sex. No significant correlations were found between AIS or ISS and age or hospital length of stay. : AIS is more anatomically focused. ISS reflects broader systemic injury patterns and is more influenced by contextual factors. These findings are particularly relevant for the Eastern European population and can help develop better healthcare policies for the region.

摘要

创伤性脑损伤(TBI)是一个重大的全球公共卫生问题,对患者有长期影响。本研究探讨了入院时用简明损伤定级标准(AIS)和损伤严重程度评分(ISS)衡量的TBI严重程度与各种社会人口学、临床及损伤相关因素之间的关系。

我们使用164例成年TBI患者的数据进行了回顾性分析。所有患者均于2020年3月至2023年6月间入住两家东欧三级医院。变量包括性别、年龄、教育程度、就业情况、婚姻状况、损伤类型和原因、损伤地点以及临床指标,如马歇尔评分、AIS和ISS。统计方法包括Pearson卡方检验、Fisher精确检验、Spearman相关性检验、Wilcoxon检验和Kruskal-Wallis检验。

大多数患者为男性(65.9%)、退休人员(59.8%)和城市居民(73.8%),平均年龄为64.98岁。最常见的损伤机制是跌倒(76.2%),通常发生在家中(61%)。主要损伤类型为闭合性颅脑外伤(93.3%)。大多数患者AIS评分较轻(75%),平均ISS为6.52(标准差:4.55)。在改良马歇尔评分类别、损伤类型和教育类别之间,AIS存在统计学显著组间差异;在改良马歇尔评分类别、损伤类型、原因和损伤地点、就业状况及性别之间,ISS存在统计学显著组间差异。未发现AIS或ISS与年龄或住院时间之间存在显著相关性。

AIS更侧重于解剖学方面。ISS反映了更广泛的全身损伤模式,且受背景因素影响更大。这些发现对东欧人群尤为重要,有助于为该地区制定更好的医疗政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9965/12429329/0add2e15e45a/jcm-14-06259-g001a.jpg

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