Vilalta J, Rubio E, Castaño C H, Guitart J M, Bosch J
Servicio de Neurocirurgía, Hospital General de la Vall d'Hebron, Universidad Autónoma de Barcelona.
Neurologia. 1993 Feb;8(2):49-52.
Some variables were analyzed in 35 patients with severe cranioencephalic injuries following a lucid interval according to mortality. The variables analyzed were: age of less than 40 years, interval of time accident-admission (TAA), admission-operation (TAO), level of consciousness (Glasgow scale), associated extracranial lesions, type of intracranial lesion, and tomodensitometric signs of intracranial hypertension. The only variables demonstrating significant statistical differences (p < 0.05) were the level of consciousness (Glasgow scale < 6 points) and the presence of subdural hematoma. Twelve (70.5%) patients who died had less than 6 on the Glasgow scale and in contrast only 5 (27.7%) of the living. Eleven (64.7%) of the group who died and 4 (22.2%) of the living had subdural hematoma. These data suggest that the level of consciousness and the type of lesion are determining factors of the mortality in this type of patients. Early detection and energic treatment of secondary lesions contribute to prognostic improvement of cranioencephalic injuries.
根据死亡率,对35例经历清醒期的重型颅脑损伤患者的一些变量进行了分析。分析的变量包括:年龄小于40岁、事故入院间隔时间(TAA)、入院手术间隔时间(TAO)、意识水平(格拉斯哥评分)、合并的颅外损伤、颅内损伤类型以及颅内高压的体层密度测量征象。显示出显著统计学差异(p < 0.05)的唯一变量是意识水平(格拉斯哥评分<6分)和硬膜下血肿的存在。死亡的12例患者(70.5%)格拉斯哥评分低于6分,相比之下,存活患者中只有5例(27.7%)。死亡组中有11例(64.7%)和存活组中有4例(22.2%)有硬膜下血肿。这些数据表明,意识水平和损伤类型是这类患者死亡率的决定因素。继发性损伤的早期发现和积极治疗有助于改善颅脑损伤的预后。