将脑损伤指南应用于创伤性脑损伤患者:当代连续系列
Julio Isidor1, Imad Samman Tahhan1, Ariana A Chacon1
1Departments of Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA.
概括
脑损伤指南 (BIG) 有效地对创伤性脑损伤 (TBI) 患者进行分层,确定需要神经外科干预的患者,并指导资源使用. 与某些BIG3病例不同,BIG1和2患者很少需要手术.
科学领域:
- 神经科学
- 医学成像
- 临床风险分层
背景情况:
- 创伤性脑损伤导致严重的长期残疾和医疗费用.
- 过度或不必要的医疗干预,包括成像和咨询, 导致TBI相关的费用.
研究的目的:
- 评估脑损伤指南 (BIG) 在治疗144名连续TBI患者中的有用性.
- 评估BIG分类与神经外科干预和资源利用的需要之间的相关性.
主要方法:
- 预期将144名TBI患者分为BIG1,2和3类.
- 对神经外科干预的回顾性评估,神经系统恶化,重复头部CT检测,以及30天后的结果.
主要成果:
- 没有BIG 1或BIG 2患者需要进行神经外科手术.
- 在重复CT时,BIG3患者的神经变化率 (24. 4%) 和出血进展率 (16. 3%) 较高,其中接受神经外科手术的患者为16. 3%.
- 与其他 BIG 3 小组和 BIG 1/2 患者相比,单独的 BIG 3 患者 (没有抗血小板/ 凝固剂) 的病情恶化和神经外科干预率更高.
结论:
- 脑损伤指南 (BIG) 作为TBI风险分层的一个有价值的工具.
- 帮助优化资源分配,包括重复成像,咨询和住院水平的决定.
- BIG分类可能为TBI患者的机构间转移决定提供指导.
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