INFLUENCE OF THE TYPE OF INTRA-CRANICAL LESION ON OUTCOME FROM SEVERE HEAD-INJURY - A MULTI-CENTER STUDY USING A NEW CLASSIFICATION-SYSTEM
INFLUENCE OF THE TYPE OF INTRA-CRANICAL LESION ON OUTCOME FROM SEVERE HEAD-INJURY - A MULTI-CENTER STUDY USING A NEW CLASSIFICATION-SYSTEM
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DOI：
10.3171/jns.1982.56.1.0026
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发表时间：
1982-01-01
影响因子：
4.1
通讯作者：
PITTS, LH
中科院分区：
文献类型：
--
作者：
GENNARELLI, TA;SPIELMAN, GM;PITTS, LH
数据来自 7 个头部损伤中心，患者符合格拉斯哥昏迷量表 [GCS] 严重头部损伤标准（GCS ≤ 8，至少 6 小时）。根据包含 2 种病变类型的简单分类系统对患者进行分类，每种病变类型又进一步细分为 2 个 GCS 评分范围（3-5 和 6-8）。在 1107 名患者中，总死亡率为 41%，但不同病变类别的死亡率在 9-74% 之间； 26% 的患者恢复良好（3 个月时），但不同病变组的恢复率范围为 6-68%。 GCS 评分为 3-5 分的急性硬膜下血肿始终是最严重的问题（死亡率为 74%，恢复良好的发生率为 8%），而 GCS 评分为 6-8 分的 6-24 小时弥漫性损伤昏迷的死亡率为 9%，恢复良好的发生率为 68%。在这个严重头部损伤组中表现出明显的异质性，并指出具有相同 GCS 评分的患者根据致病病变的不同，具有明显不同的结果。病变类型与 GCS 评分一样是决定结果的重要因素，在描述严重头部受伤患者时必须考虑这两个因素。
Data were obtained from 7 head-injury centers on patients who fulfilled the Glasgow Coma Scale [GCS] criteria for severe head injury (GCS .ltoreq. 8 for at least 6 h). Patients were categorized according to a simple classification system comprising 2 lesion types, each of which was further subdivided into 2 GCS score ranges (3-5 and 6-8). Of 1107 patients, the overall mortality was 41%, but ranged from 9-74% among the different lesion categories; 26% had good recovery (at 3 mo.) but among the different lesion groups the range was 6-68%. Acute subdural hematoma with GCS scores of 3-5 was uniformly the worst problem (74% mortality and 8% good recovery), whereas diffuse injury coma of 6-24 h with GCS scores of 6-8 had 9% mortality and 68% incidence of good recovery. Marked heterogeneity is demonstrated within this severe head-injury group and point out that patients with the same GCS score have markedly different outcomes, depending on the causative lesion. The type of lesion is as important a factor in determining outcome as is the GCS score, and both must be considered when describing severely head-injured patients.