Epidemiology and Outcomes of Acute Respiratory Distress Syndrome Following Isolated Severe Traumatic Brain Injury
Epidemiology and Outcomes of Acute Respiratory Distress Syndrome Following Isolated Severe Traumatic Brain Injury
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DOI：
10.1177/0885066620972001
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发表时间：
2020-11-15
影响因子：
3.1
通讯作者：
Krishnamoorthy, Vijay
中科院分区：
文献类型：
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作者：
Komisarow, Jordan M.;Chen, Fangyu;Krishnamoorthy, Vijay
创伤性脑损伤（TBI）患者有发生颅外并发症的风险，如急性呼吸窘迫综合征（ARDS）。我们分析了与孤立性严重TBI后ARDS相关的危险因素、死亡率和医疗利用。2007-2014年的国家创伤数据库（NTDB）数据集文件用于识别患有孤立[其他身体区域特异性简明损伤量表（AIS）< 3]重度TBI [入院总格拉斯哥昏迷量表（GCS）3 - 8和头部区域特异性AIS >3]的成人患者。比较发生ARDS和未发生ARDS患者的住院死亡率。还检查了医疗保健资源的利用（ICU住院时间、住院时间、机械通气持续时间以及气管造口术和胃造口术管放置频率）。这项回顾性队列研究纳入了38，213例患者，总体ARDS发生率为7.5%。年轻、入院时心动过速、已有的血管和呼吸系统疾病以及肺炎与ARDS的发生有关。与无ARDS的患者相比，发生ARDS的患者的住院死亡率（OR 1.13，95%CI 1.01-1.26）、住院时间（p = 0.001）、
Patients with traumatic brain injury (TBI) are at risk for extra-cranial complications, such as the acute respiratory distress syndrome (ARDS). We conducted an analysis of risk factors, mortality, and healthcare utilization associated with ARDS following isolated severe TBI. The National Trauma Data Bank (NTDB) dataset files from 2007-2014 were used to identify adult patients who suffered isolated [other body region-specific Abbreviated Injury Scale (AIS) < 3] severe TBI [admission total Glasgow Coma Scale (GCS) from 3 to 8 and head region-specific AIS >3]. In-hospital mortality was compared between patients who developed ARDS and those who did not. Utilization of healthcare resources (ICU length of stay, hospital length of stay, duration of mechanical ventilation, and frequency of tracheostomy and gastrostomy tube placement) was also examined. This retrospective cohort study included 38,213 patients with an overall ARDS occurrence of 7.5%. Younger age, admission tachycardia, pre-existing vascular and respiratory diseases, and pneumonia were associated with the development of ARDS. Compared to patients without ARDS, patients that developed ARDS experienced increased in-hospital mortality (OR 1.13, 95% CI 1.01-1.26), length of stay (p =