|
|
Analysis of influential factors of prognosis in patients with traumatic brain injury |
SUN Guo-zhang1 J IANG Feng-ling2▲ LI Ying1 MA Bo-wen1 LIU Ting1 TAO Yu1 |
1.Department of Neurosurgery,Heilongjiang Provincial Hospital,Harbin 150036,China;
2.Department of Internal Medicine,People′s Hospital of Xiangfang District,Harbin City,Heilongjiang Province,Harbin 150030,China |
|
|
Abstract Objective To analyze the influential factors of prognosis in patients with traumatic brain injury and provide scientific basis for clinical decision-making.Methods The clinical data of 67 patients with traumatic brain injury admitted to Heilongjiang Provincial Hospital from April to July 2018 were retrospectively analyzed,they were divided into good prognosis groups (37 cases) and poor prognosis group (30 cases) according to the prognosis of 3 months after discharge and different Glasgow prognosis grade (GOS).Univariate and multivariate of clinical influencing factors of prognosis in patients with traumatic brain injury were analysed.The prediction ability of Logistic regression model was evaluated by receiver operating characteristic (ROC) curve,area under the curve (AUC),sensitivity and specificity.Results Univariate analysis showed that the age,hematoma volume,blood glucose,white blood cell and neutrophil counts of the poor prognosis group were higher than those of the good prognosis group,and the Glasgow coma score (GCS) and blood calcium level at the first diagnosis were lower than those of the good prognosis group,the differences were statistically significant (P<0.05).Multivariate Logistic regression analysis showed that the first diagnosis of GCS (β=-0.367,OR=0.693,95%CI=0.554-0.867) score was a protective factor for poor prognosis in patients with traumatic brain injury.White blood cell count (β=0.249,OR=1.283,95%CI=1.053-1.562) was an independent risk factor for poor prognosis in patients with traumatic brain injury (P<0.05).Regression model AUC was 0.906,sensitivity and specificity were 93.3%and 83.8%,respectively.Conclusion The first diagnosis of GCS score and white blood cell count are independent related factors that affect the prognosis of patients with traumatic brain injury.Clinically detectable levels of the two have important significance for the prognosis of patients with brain injury.
|
|
|
|
|
[1] |
宋龄.重型颅脑损伤并发低钠血症的病因及其诊治分析[J].基层医学论坛,2019,23(20):2958-2959.
|
[2] |
黄艳玲,罗嫦粦,陈丽华,等.大埔县重型颅脑损伤患者家庭康复现状及干预需求调查[J].中国实用医药,2018,13(14):49-50.
|
[3] |
王敏红,颜颂旭.HMGB1/TLR2 表达对颅脑损伤继发认知功能障碍的作用[J].浙江创伤外科,2019,24(3):452-453.
|
[4] |
Langlois JA,Rutland-Brown W,Wald MM.The epidemiology and impact of traumatic brain injury:a brief overview[J].J Head Trauma Rehabil,2006,21(5):375-378.
|
[5] |
Jones S,Davis N,Tyson SF.A scoping review of the needs of children and other family members after a child's traumatic injury[J].Clin Rehabil,2018,32(4):501-511.
|
[6] |
Vella MA,Crandall ML,Patel MB.Acute management of traumatic brain injury[J].Surg Clin North Am,2017,97(5):1015-1030.
|
[7] |
Stein DM,Feather CB,Napolitano LM.Traumatic brain injury advances[J].Crit Care Clin,2017,33(1):1-13.
|
[15] |
张月战.颅脑损伤后早期凝血功能、血白细胞、血糖与损伤程度及预后的相关性研究[J].中国医师杂志,2014,16(11):1513-1516.
|
[8] |
Zaninotto AL,El-Hagrassy MM,Green JR,et al.Transcranial direct current stimulation(tDCS)effects on traumatic brain injury(TBI)recovery:a systematic review[J].Dement Neuropsychol,2019,13(2):172-179.
|
[9] |
Adediran T,Drumheller BC,McCunn M,et al.Sex differences in in-hospital complications among older adults after traumatic brain injury[J].J Surg Res,2019,243:427-433.
|
[10] |
Freeman AD,Fitzgerald CA,Baxter KJ,et al.Does hypertension at initial presentation adversely affect outcomes in pediatric traumatic brain injury?[J].J Pediatr Surg,2019,pii:S0022-3468(19):30 405-30 401.
|
[11] |
Yang W,Mu T,Jiang J,et al.Potential biomarkers and metabolic profiling of serum in ovarian cancer patients using UPLC/Q-TOF MS[J].Cell Physiol Biochem,2018,51:1134-1148.
|
[12] |
Gillett GR,Honeybul S,Ho KM,et al.Neurotrauma and the RUB:where tragedy meets ethics and science[J].J Med Ethics,2010,36(12):727-730.
|
[13] |
Shi J,Dong B,Mao Y,et al.Review:traumatic brain injury and hyperglycemia,a potentially modifiable risk factor[J].Oncotarget,2016,7(43):71 052-71 061.
|
[14] |
Para RA,Sarmast AH,Shah MA,et al.Our experience with management and outcome of isolated traumatic brain injury patients admitted in intensive care unit[J].J Emerg Trauma Shock,2018,11(4):288-292.
|
|
|
|