与小儿外伤性颅内出血相关的临床特征。

IF 1.8 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology Pub Date : 2024-03-07 DOI:10.1016/j.cjtee.2024.03.003

Pattama Tanaanantarak , Soraya Suntornsawat , Srila Samphao

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引用次数: 0

摘要

目的：创伤性脑损伤（TBI）可导致儿童严重的发病率和死亡率。脑 CT 是诊断颅内出血（ICH）的主要手段。本研究旨在探讨可通过脑 CT 预测小儿 TBI 患者 ICH 的临床特征，以帮助医生决定是否使用脑 CT：方法：本横断面研究共纳入了 475 名小儿创伤性脑损伤患者，这些患者于 2012 年 1 月至 2021 年 12 月期间在泰国一级创伤中心接受了伤后 24 小时内的脑 CT 检查。研究收集了临床数据和脑 CT 结果。应用逻辑回归分析评估了可预测儿童创伤性脑损伤患者脑CT上ICH的临床特征。P值小于0.05表示差异具有统计学意义。统计分析采用 R 软件 3.6.1 版：纳入病例的平均年龄为 7.7 岁（四分位距（IQR）为 3.5 - 12.6 岁）。98例（20.63%）儿科患者根据脑CT结果发现了ICH。在多变量分析中，高钝能损伤（几率比（OR）= 2.79，95% CI 1.27 - 6.11，P = 0.010）、机动车事故（OR = 2.04，95% CI：1.14 - 3.67，P = 0.017）、格拉斯哥昏迷量表评分结论：这些因素可能有助于临床医生做出判断：这些因素可能有助于临床医生就小儿创伤性脑损伤病例中脑 CT 的使用做出适当的决定。

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Clinical characteristics associated with pediatric traumatic intracranial hemorrhage

Purpose

Traumatic brain injury (TBI) can cause significant morbidity and mortality in the pediatric population. Brain CT is the mainstay in the diagnosis of intracranial hemorrhage (ICH). The aim of this study was to explore the clinical characteristics that can predict ICH on brain CT in pediatric TBI patients, to assist physicians in deciding on the use of brain CT.

Methods

A total of 475 pediatric TBI patients who underwent brain CT within 24 h after injury from January 2012 to December 2021 in the level 1 trauma center in Thailand were included in this cross-sectional study. Clinical data and brain CT findings were collected. Logistic regression analysis was applied to evaluate clinical characteristics that could predict ICH on brain CT in pediatric TBI patients. A p value was less than 0.05 being indicated that the difference is statistically significant. R software version 3.6.1 was used to statistical analysis.

Results

The included cases have a median (Q₁, Q₃) age of 7.7 (3.5, 12.6) years. ICH was found in 98 (20.6%) pediatric patients based on brain CT findings. On multivariable analysis, high blunt energy injury (odds ratio (OR) = 2.79, 95% CI 1.27 – 6.11, p = 0.010), motor vehicle accidents (OR = 2.04, 95% CI: 1.14 – 3.67, p = 0.017), Glasgow coma scale score <13 (OR = 4.28, 95% CI: 1.87 – 9.78, p < 0.001), palpable skull fractures (OR = 7.30, 95% CI: 1.44 – 37.04, p = 0.016), signs of basilar skull fracture (OR = 6.10, 95% CI: 2.16 – 17.24, p < 0.001), and vomiting ≥ 3 times (OR = 2.60, 95% CI: 1.17 – 5.77, p = 0.022) were statistically significant predictive factors for ICH in pediatric TBI patients.

Conclusion

These factors might aid clinicians in making an appropriate decision regarding the use of brain CT in pediatric TBI cases.

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来源期刊

Chinese Journal of Traumatology ORTHOPEDICS-

CiteScore

3.80

自引率

4.80%

发文量

1707

审稿时长

28 weeks

期刊介绍： Chinese Journal of Traumatology (CJT, ISSN 1008-1275) was launched in 1998 and is a peer-reviewed English journal authorized by Chinese Association of Trauma, Chinese Medical Association. It is multidisciplinary and designed to provide the most current and relevant information for both the clinical and basic research in the field of traumatic medicine. CJT primarily publishes expert forums, original papers, case reports and so on. Topics cover trauma system and management, surgical procedures, acute care, rehabilitation, post-traumatic complications, translational medicine, traffic medicine and other related areas. The journal especially emphasizes clinical application, technique, surgical video, guideline, recommendations for more effective surgical approaches.