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轻度创伤性脑损伤:并不总是轻度损伤

Morgan Schellenberg¹, Miharu Arase², Monica D Wong²

¹Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, 2051 Marengo Street, Inpatient Tower, C5L100, Los Angeles, CA, 90033, USA. morgan.schellenberg@med.usc.edu.

European journal of trauma and emergency surgery : official publication of the European Trauma Society

|October 16, 2023

概括

老年患者,特别是那些患有并发症或需要输管并经历低血压的患者,在轻度创伤性脑损伤 (TBI) 后面临更高的死亡风险. 警和观察对于这些患者至关重要.

科学领域:

创伤外科手术是什么
神经临界护理是指神经临界护理.
公共卫生公共卫生

背景情况:

创伤后的死亡风险通常与受伤严重程度相关.
然而,一些患有轻度创伤性脑损伤 (TBI) 并且到达稳定的病情的患者仍然面临住院死亡的风险.

研究的目的:

为了确定在轻度隔离TBI后在医院死亡的患者.
为患者和家属的急诊部 (ED) 处置和护理讨论提供信息.

主要方法:

使用2007-2018年国家创伤数据库 (NTDB) 进行的回顾性队列研究.
包括患有形创伤和轻度TBI (头部AIS 1-2,GCS 13-15),不包括严重的相关伤害的患者.
使用单变量和多变量分析,比较人口统计,临床/受伤数据以及幸存者和非幸存者之间的结果.

主要成果:

超过932,000名患者符合标准;0.4%的患者在医院死亡.
在那些死亡的人中,并发病更为常见,而在幸存者中,中毒更为频繁.
死亡率的独立预测因素包括65岁以上,ED输管,入院低血压,末期病 (ESRD) 和免疫抑制.

结论:

死亡的轻度TBI患者与幸存者在并发症,中毒和保险状况方面有很大的不同.
预测医院死亡的关键因素是晚年,ED输管,低血压,ESRD和免疫抑制.
建议增加高风险患者的临床警和观察期,以改善结果.

关键词:

轻微的创伤是轻微的创伤.创伤死亡率的死亡率.创伤性脑损伤是一种创伤性脑损伤.

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