Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015.
Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015.
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DOI：
10.1186/s13049-018-0546-6
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发表时间：
2018-09-10
期刊：
影响因子：
--
通讯作者：
TraumaRegister DGU
中科院分区：
文献类型：
--
作者：
Huckhagel T;Nüchtern J;Regelsberger J;Lefering R;TraumaRegister DGU
外周神经损伤（PNI）作为上肢创伤患者的辅助病变，尽管其具有破坏性的长期后果，但迄今为止尚未在中欧环境中进行研究。本研究评估了一个大型多国创伤登记处上肢神经病变的患病率，机制，损伤严重程度和结局特征。正式批准后，在TraumaRegister DGU®（TR-DGU）中检索了2002年至2015年间累及上肢的严重损伤病例。根据伴发神经损伤的情况，将患者分为两组。对于所有病例，获得人口统计学数据、创伤机制、伴随病变、损伤严重程度和结局特征，并进行组间比较。约3.3%的上肢受累创伤患者（n = 49，382）显示额外的神经损伤。PNI病例更可能是男性（78.6% vs.73.2%），并且往往比没有神经病变的患者明显年轻（平均年龄40.6岁vs.47.2岁）。摩托车事故是PNI患者中最常见的单一损伤原因（32.5%），而对照组病例主要由高处或低处福尔斯跌倒造成创伤（32.2%）。PNI患者中识别的典型病变为肱骨（37.2%）或尺骨（20.3%）骨折、血管撕裂（动脉10.9%;静脉2.4%）和广泛软组织损伤（21.3%）。尽管两组的平均创伤严重程度相似，但神经病变患者的住院时间较长（30.6 d vs. 24.2 d），需要更多的后续住院康复（36.0% vs. 29.2%）。PNI并发上肢创伤可能更常见于中欧比以往的国外研究所建议的。PNI通常影响年轻男性，他们的住院时间显着增加，随后需要住院康复。因此，这些病变除了影响个体患者的健康相关生活质量外，还会引起非常高的财务费用。有必要进一步研究，以制定针对此类创伤的具体预防策略。
Peripheral nerve injury (PNI) as an adjunct lesion in patients with upper extremity trauma has not been investigated in a Central European setting so far, despite of its devastating long-term consequences. This study evaluates a large multinational trauma registry for prevalence, mechanisms, injury severity and outcome characteristics of upper limb nerve lesions. After formal approval the TraumaRegister DGU® (TR-DGU) was searched for severely injured cases with upper extremity involvement between 2002 and 2015. Patients were separated into two cohorts with regard to presence of an accompanying nerve injury. For all cases demographic data, trauma mechanism, concomitant lesions, severity of injury and outcome characteristics were obtained and group comparisons performed. About 3,3% of all trauma patients with upper limb affection (n = 49,382) revealed additional nerve injuries. PNI cases were more likely of male gender (78,6% vs.73,2%) and tended to be significantly younger than their counterparts without nerve lesions (mean age 40,6 y vs. 47,2 y). Motorcycle accidents were the most frequently encountered single cause of injury in PNI patients (32,5%), whereas control cases primarily sustained their trauma from high or low falls (32,2%). Typical lesions recognized in PNI patients were fractures of the humerus (37,2%) or ulna (20,3%), vascular lacerations (arterial 10,9%; venous 2,4%) and extensive soft tissue damage (21,3%). Despite of similar average trauma severity in both groups patients with nerve affection had a longer primary hospital stay (30,6 d vs. 24,2 d) and required more subsequent inpatient rehabilitation (36,0% vs. 29,2%). PNI complicating upper extremity trauma might be more commonly encountered in Central Europe than suggested by previous foreign studies. PNI typically affect males of young age who show significantly increased length of hospitalization and subsequent need for inpatient rehabilitation. Hence these lesions induce extraordinary high financial expenses besides their impact on health related quality of life for the individual patient. Further research is necessary to develop specific prevention strategies for this kind of trauma.
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10.1016/j.injury.2012.12.007
发表时间：
2013-08-01
影响因子：
2.5
作者：
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发表时间：
2010-05-01
影响因子：
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作者：
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