不同性别的创伤性脑损伤患者的发病率、临床表现、治疗和预后的差异
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北部战区总医院

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辽宁省科学技术计划项目(2022JH2/101500037)


Differences in incidence, clinical characteristics, treatment, and prognosis of traumatic brain injury patients by gender
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General Hospital of Northern Theater Command

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    目的 探讨性别对创伤性脑损伤(Traumatic Brain Injury,TBI)患者发病率、临床表现、治疗和预后的影响。方法 回顾性分析2012年至2023年在北部战区总医院神经外科住院的1218名TBI患者的临床资料,比较不同性别患者在年龄、受伤原因、格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)、损伤类型和预后情况等方面的差异,并采用Logistic回归分析性别对预后的影响。结果 男性患者比例显著高于女性(80.0% vs. 20.0%,P< 0.001),女性患者平均年龄高于男性(54.28岁 vs. 50.04岁,P = 0.006)。女性患者主要因交通事故受伤,男性患者则多因高空坠落致伤。多变量Logistic回归分析显示,年龄、交通事故、GCS评分≤ 8、硬膜下血肿和硬膜外血肿是TBI患者死亡的独立预测因素。结论 性别对TBI患者的发病率和临床表现有显著影响,男性发病率更高,女性患者年龄偏大且受伤原因主要为交通事故。年龄、交通事故、低GCS评分、硬膜下血肿和硬膜外血肿是TBI患者死亡的关键预测因素。针对不同性别和年龄段的患者应制定差异化的预防和治疗策略,以提高预后并降低死亡率。

    Abstract:

    Objective Traumatic Brain Injury (TBI) is a brain dysfunction caused by an external force impact or penetration to the head. In recent years, the incidence and associated mortality of TBI have been increasing annually, posing significant challenges to the healthcare system and the socio-economic environment. This study aims to investigate the impact of sex on the incidence, clinical presentation, treatment, and prognosis of TBI patients. Methods A retrospective analysis was conducted on the clinical data of 1,218 TBI patients hospitalized in the Department of Neurosurgery at Northern Theater General Hospital from 2012 to 2023. The data included age, sex, cause of injury, Glasgow Coma Scale (GCS) score, injury type, and prognosis. Chi-square tests and logistic regression analysis were used to evaluate the impact of sex on the prognosis of TBI patients. Results The results showed that the proportion of male patients was significantly higher than that of female patients (80.0% vs. 20.0%, P<0.001), and the average age of female patients was higher than that of male patients (54.28 years vs. 50.04 years, P = 0.006). Traffic accidents were the main cause of injury for female patients, whereas falls from heights were the primary cause for male patients. Multivariate logistic regression analysis revealed that age, traffic accidents, GCS score ≤ 8, subdural hematoma, and epidural hematoma were independent predictors of mortality in TBI patients. Conclusion Sex significantly impacts the incidence and clinical characteristics of TBI. Male patients have a higher incidence of TBI, while female patients are generally older and primarily injured due to traffic accidents. Age, traffic accidents, low GCS scores, subdural hematoma, and epidural hematoma are independent predictors of mortality in TBI patients. Therefore, different prevention and treatment strategies should be developed for TBI patients based on their sex and age to improve prognosis and reduce mortality rates.

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  • 收稿日期:2024-07-11
  • 最后修改日期:2024-08-29
  • 录用日期:2024-09-04
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