Outcomes of Patients with Severe Traumatic Brain Injury Who Have Glasgow Coma Scale Scores of 3 or 4 and Are Over 65 Years Old
Outcomes of Patients with Severe Traumatic Brain Injury Who Have Glasgow Coma Scale Scores of 3 or 4 and Are Over 65 Years Old
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DOI：
10.1089/neu.2010.1315
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发表时间：
2010-09-01
影响因子：
4.2
通讯作者：
Rusnak, Martin
中科院分区：
文献类型：
--
作者：
Brazinova, Alexandra;Mauritz, Walter;Rusnak, Martin
本研究的目的是调查格拉斯哥昏迷量表（GCS）评分为3或4分且年龄≥ 66岁的创伤性脑损伤（TBI）患者的结局。2001年1月至2005年12月，13个欧洲中心招募了严重脑外伤患者。对GCS评分为3或4分且年龄≥ 66岁的所有患者的数据集进行分析。根据创伤后12个月的格拉斯哥结局量表（GOS）将结局分为“有利”（GOS评分为4或5分）或“不利”（GOS评分为1-3分）;比较两组患者的相关数据。通过单变量分析（卡方、Wilcoxon-Mann-Whitney和Fisher精确检验）分析变量，p值15 mm也与不利结局相关，蛛网膜下腔出血（SAH）也是如此。GCS评分为3或4分的65岁以上的患者预后较差，但并非毫无希望。本组患者预后不良的确定因素为首次CT扫描时基底池闭合和中线移位> 15 mm。可能与有利结局相关的因素包括女性、创伤严重程度较低、基底池开放或部分开放以及首次CT扫描时中线无移位。
The goal of this study was to investigate the outcomes of patients with traumatic brain injury (TBI) who had Glasgow Coma Scale (GCS) scores of 3 or 4, and were aged 66 years or older. Between January 2001 and December 2005, 13 European centers enrolled patients with severe brain trauma. Data sets of all patients who had a GCS score of 3 or 4 and were 66 years of age or older were analyzed. Outcomes were classified according to the Glasgow Outcome Scale (GOS) 12 months post-trauma as "favorable" (GOS score of 4 or 5), or "unfavorable" (GOS score of 1-3); relevant data for patients of the two groups were compared. Variables were analyzed by univariate analyses (chi-square, Wilcoxon-Mann-Whitney, and Fisher's exact tests), and a p value of 15mm were also associated with unfavorable outcomes, as was subarachnoid hemorrhage (SAH). Patients with GCS scores of 3 or 4 who are older than 65 years have a poor, but not hopeless, prognosis. Confirmed factors predicting poor prognosis for this group of patients were closed basal cisterns and midline shift >15mm on the first CT scan. Factors possibly related to favorable outcomes were female gender, lower trauma severity, open or partially open basal cisterns, and no midline shift on the first CT scan.