Cognitive deficits in presumed minor head-injured patients.
Cognitive deficits in presumed minor head-injured patients.
复制标题
推测的轻微头部受伤患者的认知缺陷。
DOI：
10.1111/j.1553-2712.1996.tb03297.x
复制
发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Elaine Koutanis
中科院分区：
文献类型：
--
作者：
Daniel P. Stewart;Jeffrey Kaylor;Elaine Koutanis
客观化
目的：确定轻度颅脑损伤患者中认知功能障碍的发生率，并找出这些患者的初始病史和体格检查中预测认知功能障碍的因素。
方法
一项为期9个月的前瞻性临床研究在大型社区ED(每年60,000名患者普查)中进行。这些患者年龄在16岁到50岁之间，在急诊室就诊时有头部钝挫伤或减速伤病史，格拉斯哥昏迷评分(GCS)为14或15分。住进医院或对头骨或大脑进行异常成像研究的患者也被排除在外。使用标准化数据表格收集详细的病史和体检结果。在伤后一周进行认知测试(Halstead-Reitan神经心理成套测验)。
结果
最初有70名患者进入研究，36名患者完成了随访。完成这项研究的人就业更普遍，不太可能使用过改变感觉的药物或乙醇。在完成这项研究的36名患者中，42%的患者在受伤后一周有轻度或中度认知障碍。初诊时小脑功能异常与随访时存在认知障碍有关(p=0.004)。然而，在15名有认知缺陷的患者中，只有4名(27%；95%可信区间8-55%)有异常的小脑发现。
结论
许多头部轻微损伤的患者在受伤后一周就会出现认知障碍。病史和体检特征不能很好地预测这些缺陷。需要进一步的研究来评估这些认知缺陷的持续时间和最终结果。
OBJECTIVE
To determine the frequency of cognitive deficits in ED patients with presumed minor head injury and to identify factors in the initial history and physical examination predictive of cognitive deficits in these patients.
METHODS
A prospective clinical study was performed over a nine-month period at a large community-based ED (60,000 patient annual census). Consecutive patients between 16 and 50 years of age who presented to the ED with a history of blunt trauma or a deceleration injury to the head and a Glasgow Coma Scale (GCS) score of 14 or 15 were included. Patients who were admitted to the hospital or who had an abnormal imaging study of the skull or brain also were excluded. Detailed history and physical examination findings were collected using a standardized data form. Cognitive testing was done at one week postinjury (Halstead-Reitan Neuropsychological Test Battery).
RESULTS
Seventy patients were originally entered into the study, and 36 completed the follow-up. Those completing the study were more commonly employed and less likely to have used sensorium-altering drugs or ethanol. Of the 36 patients who completed the study, 42% had either mild or moderate cognitive deficits at one week postinjury. Abnormal cerebellar function during the initial visit was associated with the presence of cognitive deficits at follow-up (p = 0.004). However, only four of 15 (27%; 95% CI 8-55%) patients with a cognitive deficit had an abnormal cerebellar finding.
CONCLUSION
Many patients with minor head injuries have cognitive deficits one week after injury. History and physical examination features are poor predictors of these deficits. Further studies are needed to evaluate the duration and final outcome of these cognitive deficits.
轻度颅脑损伤分类。
影响因子：
4.8
作者：
Williams,DH;Levin,HS;Eisenberg,HM
通讯作者：
Eisenberg,HM