在过渡中迷失:创伤性脑损伤患者的长期随访
Marco J Henriquez1, Danyi Wang1, Fabiana C Sanchez1
1Section of Acute & Critical Care Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
The Journal of surgical research
|December 17, 2025
概括
近一半的创伤性脑损伤 (TBI) 患者错过了门诊随访,阻碍了恢复. 辅助服务转诊率极低,这表明TBI幸存者的急性后护理存在重大差距.
科学领域:
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
- 创伤外科 手术 创伤外科
背景情况:
- 创伤性脑损伤 (TBI) 是导致长期残疾的主要原因.
- 有效的门诊随访对于管理TBI缺口和改善结果至关重要.
- 目前的TBI护理途径可能无法充分支持出院后的康复.
研究的目的:
- 评估TBI患者医院出院后门诊随访率.
- 评估TBI幸存者的辅助服务的利用情况.
- 确定与后续遵守和服务利用相关的因素.
主要方法:
- 追溯分析了2022年1月至2024年1月期间入院的1142名TBI患者.
- 图表审查以确定出院后的预约和转诊,以进行物理治疗,职业治疗,语音语言病理学和神经认知测试.
- 多变量分析以确定后续和辅助服务使用的预测因素.
主要成果:
- 53%的TBI患者参加了门诊随访,大多数在神经外科诊所进行常规护理.
- 辅助服务推不常见 (<2%),对生活质量或认知/行为变化的讨论有限.
- 出院到非康复设施和无保险身份与较低的随访率有关;较高的伤害严重程度和解压性脑切除术与随访的增加有关.
结论:
- 很大一部分TBI患者没有获得必要的门诊随访护理.
- 辅助服务的低利用率凸显了急性TBI后管理中的关键差距.
- 需要有针对性的干预措施来加强对TBI幸存者的随访遵守和综合护理.
相关概念视频
01:28Traumatic Brain Injury l: Introduction
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...
01:25Secondary Spinal Cord Injury llI: Pathophysiology
Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...