在患有先发性精神疾病的患者中,严重创伤性脑损伤的结果
Justin N Passman1, Nathaniel A Cleri1, Jermaine Robertson1
1Department of Neurosurgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
World neurosurgery
|November 1, 2024
概括
患有精神疾病 (PI) 和物质使用障碍 (SUD) 的人在严重创伤性脑损伤 (TBI) 后表现出更好的生存和恢复. 然而,他们的住院时间更长,表明更复杂的护理需求.
科学领域:
- 神经科学是一个神经科学.
- 创伤外科 手术 创伤外科
- 精神病学是一个精神病学.
背景情况:
- 患有精神疾病 (PI) 的人患创伤性脑损伤 (TBI) 的比率更高.
- 预先存在的PI对TBI结果的影响仍然不清楚.
- 了解这些影响对于改善患者护理至关重要.
研究的目的:
- 调查预发性精神疾病 (PI) 与严重创伤性脑损伤 (TBI) 后的结果之间的关联.
- 将TBI患者的PI (心理 (+)) 和物质使用障碍 (SUD (+)) 的结果与没有PI (心理 (-)) 的患者进行比较.
主要方法:
- 对633名成人严重TBI患者 (2010-2021) 的医疗记录进行分析.
- 分类为心理 (+) (n=129),SUD (+) (n=60) 和心理 (-) (n=480) 组.
- 结果指标包括格拉斯哥昏迷量表 (GCS),停留时间,存活率和格拉斯哥结果量表-扩展 (GOS-E).
主要成果:
- 心理 (+) 和SUD (+) 组与心理 (-) 组相比,在医院的存活率显著更高.
- 患有PI和SUD的患者较少出现严重出院的情况.
- 心理 (+) 和SUD (+) 两组都经历了更长的住院时间.
- 心理 (+) 和SUD (+) 组在退院时,TBI后6个月和1年表现出更好的GOS-E分数.
- 两组之间没有观察到受伤严重程度或CT扫描结果的显著差异.
结论:
- 病前精神疾病和物质使用障碍与严重TBI后更好的生存和功能恢复有关.
- 尽管结果有所改善,但这些患者群体的住院时间较长,这表明护理复杂性增加.
- 需要进一步的研究来阐明驱动这些差异性结果的潜在机制.
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