Mortality-Associated Characteristics of Patients with Traumatic Brain Injury at the University Teaching Hospital of Kigali, Rwanda
Mortality-Associated Characteristics of Patients with Traumatic Brain Injury at the University Teaching Hospital of Kigali, Rwanda
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DOI：
10.1016/j.wneu.2017.03.001
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发表时间：
2017-06-01
影响因子：
2
通讯作者：
Thielman, Nathan M.
中科院分区：
文献类型：
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作者：
Krebs, Elizabeth;Gerardo, Charles J.;Thielman, Nathan M.
目的：创伤性脑损伤是导致人类死亡和致残的主要原因。低收入和中等收入国家的TBI患者的预后比高收入国家的患者更差。我们在卢旺达基加利的基加利大学教学医院评估了与脑外伤患者死亡率相关的重要临床指标。方法：对到基加利大学教学医院急诊科就诊的脑损伤患者进行前瞻性连续抽样，筛选纳入标准：报告的头部创伤、意识改变、头痛和明显的头部创伤。排除标准为受伤后48小时的年龄和重复就诊。使用Logistic回归对数据与死亡的相关性进行评估。结果：在2013年10月7日至2014年4月6日期间，共纳入684例患者，其中14例(2%)因资料不完整而被排除。在患者中，81%是男性，平均年龄31岁(范围10-89岁；SD 11.8)。大多数患者(80%)为轻度(格拉斯哥昏迷评分13~15分)，10%为中度(GCS评分9~12分)，10%为重度(GCS评分3~8分)。多因素Logistic回归分析显示GCS评分50岁与死亡显著相关。结论：GCS评分50岁与死亡率相关。这些发现为未来的研究提供了信息，这些研究可能会指导临床医生优先照顾死亡风险最高的患者。
OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of death and disability. Patients with TBI in low and middle-income countries have worse outcomes than patients in high-income countries. We evaluated important clinical indicators associated with mortality for patients with TBI at University Teaching Hospital of Kigali, Kigali, Rwanda.METHODS: A prospective consecutive sampling of patients with TBI presenting to University Teaching Hospital of Kigali Accident and Emergency Department was screened for inclusion criteria: reported head trauma, alteration in consciousness, headache, and visible head trauma. Exclusion criteria were age 48 hours after injury, and repeat visit. Data were assessed for association with death using logistic regression. Significant variables were included in a multivariate logistic regression model and refined via backward elimination.RESULTS: Between October 7, 2013, and April 6, 2014, 684 patients were enrolled; 14 (2%) were excluded because of incomplete data. Of patients, 81% were male with mean age of 31 years (range, 10-89 years; SD 11.8). Most patients (80%) had mild TBI (Glasgow Coma Scale [GCS] score 13-15); 10% had moderate (GCS score 9-12) and 10% had severe (GCS score 3-8) TBI. Multivariate logistic regression determined that GCS score 50 years were significantly associated with death.CONCLUSIONS: GCS score 50 years were associated with mortality. These findings inform future research that may guide clinicians in prioritizing care for patients at highest risk of mortality.