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减少儿童轻度创伤性脑损伤的住院治疗:全国性的观察性研究

Nora Bruns¹, Rayan Hojeij², Pia Brensing²

¹Department of Pediatrics I, Neonatology, Pediatric Intensive Care Medicine, Pediatric Neurology, and Pediatric Infectious Diseases, University Hospital Essen, Essen, Germany nora.bruns@uk-essen.de.

BMJ paediatrics open

|September 23, 2025

概括

2020年,儿童的创伤性脑损伤 (TBI) 住院病例减少,轻度TBI病例显示最大的减少. 这表明,较轻微的TBI病例可以在门诊治疗.

科学领域:

儿科急救医学儿科急救医学
神经创伤研究神经创伤研究
公共卫生监督公共卫生监督

背景情况:

创伤性脑损伤 (TBI) 是儿童的一个重大问题,轻度TBI (mTBI) 是最常见的形式.
德国的儿童TBI住院率特别高,这可能表明轻微病例的入院过度.
了解住院趋势和可变性对于优化儿科TBI护理至关重要.

研究的目的:

分析2014年至2020年德国18岁以下患者TBI相关住院的趋势.
调查不同儿科急诊部 (ED) 的TBI住院率的变化.

主要方法:

一项使用德国医院数据集 (GHD) 的回顾性观察研究.
使用ICD-10代码识别病例,使用头部受伤的缩写伤害量表 (AIS) 评估严重程度.
分析了来自18家参与的儿科ED的数据,以比较住院患者与门诊患者的管理比例.

主要成果:

总共有618,577个TBI病例被分析,每年住院病例从2014-2019年的91,299人减少到2020年的70,783人.
与参考期相比,2020年所有原因和mTBI入院的标准化发病率 (SMR) 显著下降.
住院率在EDs之间差异很大,从19.1%到93.0% (中位数75.0%).

结论:

在COVID-19大流行期间,mTBI住院病例的不成比例下降表明,可能会增加轻度TBI病例的门诊管理.
住院实践的变化突出了在儿科TBI管理中标准化护理和改善资源配置的机会.

关键词:

儿童健康儿童健康

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Traumatic Brain Injury l: Introduction

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DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...