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创伤性脑损伤的老年患者的神经外科治疗:20年的随访研究

Rebeca Alejandra Gavrila Laic¹, Jos Vander Sloten¹, Bart Depreitere²

¹Biomechanics Section, KU Leuven, Belgium.

|June 29, 2023

概括

需要手术的急性亚皮血瘤 (aSDH) 的老年患者在早期干预时的结果更糟. 推迟手术或保守的管理,当可行时,在这个脆弱的人群中显示出更好的结果.

科学领域:

神经外科神经外科
老年医学老年医学
创伤学创伤学创伤学

背景情况:

创伤性脑损伤 (TBI) 显著影响老年患者的生活质量.
老年人TBI的最佳治疗策略,特别是急性腹腔内血瘤 (aSDH),仍然难以确定.

研究的目的:

评估 65 岁及以上患者急性腹腔内血瘤 (aSDH) 疏散的结果.
为了比较早期手术,延迟手术和老年人SDH的保守管理.

主要方法:

对2999名年龄≥65岁的TBI患者的临床记录进行手动查.
149名aSDH患者的鉴定,分类为早期手术,延迟手术或保守治疗.

主要成果:

早期手术患者呈现较低的GCS得分和较差的结果.
在早期手术组 (21.9%) 的30天死亡率最高,而延迟手术 (3.0%) 和保守管理 (16.7%) 的死亡率最高.
保守的管理显示出比延迟手术更糟糕的结果,这表明如果初始GCS足够,警等待的潜在好处.

结论:

患有SDH的老年患者接受了早期手术,表现和结果最差.
延迟手术或保守的治疗可能与特定患有SDH的老年患者的更好的结果有关.
需要进一步的前性研究来确认老年TBI患者的SDH手术干预的最佳时间.

关键词:

临床管理临床管理年长的老人.神经外科神经外科结果结果的结果.追溯研究是一项回顾性研究.创伤性脑损伤是一种创伤性脑损伤.

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Traumatic Brain Injury l: Introduction

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