One-Year Mortality after Traumatic Brain Injury in Liver Cirrhosis Patients--A Ten-Year Population-Based Study.
One-Year Mortality after Traumatic Brain Injury in Liver Cirrhosis Patients--A Ten-Year Population-Based Study.
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DOI：
10.1097/md.0000000000001468
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发表时间：
2015-10
期刊：
影响因子：
1.6
通讯作者：
Kuo JR
中科院分区：
文献类型：
--
作者：
Cheng CY;Ho CH;Wang CC;Liang FW;Wang JJ;Chio CC;Chang CH;Kuo JR
本研究使用台湾全国性数据库，调查了创伤性脑损伤（TBI）后接受脑外科手术且同时患有酒精性和/或非酒精性肝硬化（LC）的患者的1年死亡率。采用1997年1月至2007年12月台湾国家健康保险研究数据库，对合并酒精性和/或非酒精性LC的TBI患者和未合并LC的TBI患者进行了一项纵向队列研究，其倾向评分与年龄、性别、ICU住院时间、HTN、DM、MI、卒中、HF、肾脏疾病和TBI诊断年份相匹配。研究的主要结局是1年死亡率。总共有7296例受试者（2432例TBI伴LC患者和4864例TBI不伴LC患者）入组本研究。主要发现：（1）TBI合并LC患者1年病死率较高（52.18%比30.61%）和1.75倍的死亡风险增加与非LC TBI患者相比，（2）肾脏疾病和HF是急性TBI患者的危险因素，而高血压可能是保护因素，（3）TBI合并非酒精性LC及酒精性和非酒精性LC并存患者的1年病死率高于TBI合并酒精性肝硬化患者。这项研究表明，接受过脑部手术的LC患者可能比未接受LC的患者1年死亡率更高。此外，非酒精性以及酒精性和非酒精性LC共存的TBI合并LC患者的1年死亡风险高于酒精性LC患者，尤其是合并高血压、糖尿病和卒中的患者。
This study investigated the 1-year mortality of patients who underwent brain surgery following traumatic brain injury (TBI) who also had alcoholic and/or nonalcoholic liver cirrhosis (LC) using a nationwide database in Taiwan. A longitudinal cohort study matched by propensity score with age, gender, length of ICU stay, HTN, DM, MI, stroke, HF, renal diseases, and year of TBI diagnosis in TBI patients with alcoholic and/or nonalcoholic LC and TBI patients without LC was conducted using the National Health Insurance Research Database in Taiwan between January 1997 and December 2007. The main outcome studied was 1-year mortality. In total, 7296 subjects (2432 TBI patients with LC and 4864 TBI patients without LC) were enrolled in this study. The main findings were (1) TBI patients with LC had a higher 1-year mortality (52.18% vs 30.61%) and a 1.75-fold increased risk of mortality (95% CI 1.61–1.90) compared with non-LC TBI patients, (2) renal diseases and HF are risk factors, but hypertension could be a protective factor in cirrhotic TBI patients, and (3) TBI patients with non-alcoholic LC and the coexistence of alcoholic and nonalcoholic LC had higher 1-year mortality compared with TBI patients with alcoholic cirrhosis. This study showed that patients with LC who have undergone brain surgery might have higher risk of 1-year mortality than those without LC. In addition, nonalcoholic and the coexistence of alcoholic and nonalcoholic LC show higher 1-year mortality risk than alcoholic in TBI patients with LC, especially in those with comorbidities of hypertension, diabetes mellitus, and stroke.