使用重大头部损伤后皮质类固醇随机化(CRASH)预后模型作为中低收入国家接受手术的脑外伤患者的死亡率预测指标》(The Use of Corticosteroid Randomisation after Significant Head Injury (CRASH) Prognostic Model as Mortality Predictor of Traumatic Brainjury Patients Underwed Surgery in Low-Middle Income Countries)。

IF 1.6 Q2 ANESTHESIOLOGY
Anesthesiology Research and Practice Pub Date : 2024-06-21 eCollection Date: 2024-01-01 DOI:10.1155/2024/5241605
Radian A Halimi, Iwan Fuadi, Dionisius Alby
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引用次数: 0

摘要

背景:创伤性脑损伤(TBI)是指由碰撞、打击或穿透性损伤等创伤引起的正常脑功能紊乱。影响患者预后的一些因素也具有预测价值。来自中低收入国家的有限数据显示,创伤性脑损伤患者的不良预后较多。重大头部损伤后的皮质类固醇随机化(CRASH)预后模型是一种使用此类因素的预测模型,通常用于发达国家。该模型具有出色的判别能力。然而,在中低收入国家仍缺乏将其用于外科手术患者的研究。本研究旨在评估 CRASH 模型在预测中低收入国家接受手术的创伤性脑损伤患者 14 天死亡率方面的有效性:这项回顾性分析观察研究采用总体抽样法,包括2022年1月至12月期间接受全身麻醉手术的所有创伤性脑损伤患者。统计分析采用曼-惠特尼检验和费舍尔精确检验,而模型的判别能力则通过计算曲线下面积(AUC)来确定:研究期间共收治 112 名创伤性脑损伤患者,其中 74 名患者被纳入研究范围。独立统计分析显示,14 天死亡风险、年龄、格拉斯哥昏迷量表评分、创伤性脑损伤严重程度、瞳孔反应和主要颅外创伤与患者的实际死亡结果有显著的个体相关性(P < 0.05)。AUC分析显示死亡率预测效果极佳(AUC 0.838;CI 95%):CRASH预后模型在预测中低收入国家接受手术的创伤性脑损伤患者的14天死亡率方面表现良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Use of Corticosteroid Randomisation after Significant Head Injury (CRASH) Prognostic Model as Mortality Predictor of Traumatic Brain Injury Patients Underwent Surgery in Low-Middle Income Countries.

Background: Traumatic brain injury (TBI) is a disruption to normal brain functions caused by traumas such as collisions, blows, or penetrating injuries. There are factors affecting patient outcomes that also have a predictive value. Limited data from low-middle income countries showed a high number of poor outcomes in TBI patients. The corticosteroid randomisation after significant head injury (CRASH) prognostic model is a predictive model that uses such factors and is often used in developed countries. The model has an excellent discriminative ability. However, there is still a lack of studies on its use in surgical patients in low-middle income countries. This study aimed to evaluate the CRASH model's validity to predict 14-day mortality of TBI patients who underwent surgery in low-middle income countries.

Methods: This retrospective analytical observational study employed total sampling including all TBI patients who underwent surgery with general anesthesia from January to December 2022. Statistical analysis was performed by applying Mann-Whitney and Fisher exact tests, while the model's discriminative ability was determined through the area under the curve (AUC) calculations.

Results: 112 TBI patients were admitted during the study period, and 74 patients were included. Independent statistical analysis showed that 14-day mortality risk, age, Glasgow Coma Scale score, TBI severity, pupillary response, and major extracranial trauma had a significant individual correlation with patients' actual mortality outcome (p < 0.05). The AUC analysis revealed an excellent mortality prediction (AUC 0.838; CI 95%).

Conclusion: The CRASH prognostic model performs well in predicting the 14-day mortality of TBI patients who underwent surgery in low-middle income countries.

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来源期刊
CiteScore
3.10
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29
审稿时长
18 weeks
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