脑外伤后消化道出血:关于诱发因素和结果的临床研究。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL
Caspian Journal of Internal Medicine Pub Date : 2024-09-07 eCollection Date: 2024-01-01 DOI:10.22088/cjim.15.4.673
Mehdi Mahmoodkhani, Arvin Naeimi, Amirhosein Zohrehvand, Masih Sabouri, Mohammad Heidari
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引用次数: 0

摘要

背景:创伤性脑损伤(TBI)是导致全球死亡和残疾的最常见原因之一。应激性溃疡在重症患者中很常见,可导致危及生命的消化道出血(GIB)。本研究调查了易感因素对创伤性胃肠道出血的影响以及创伤性胃肠道出血患者的预后:这项回顾性队列研究纳入了2019年2月至2021年11月期间收治的创伤性脑损伤患者。研究收集了患者的人口统计学信息和临床特征,并将其分为创伤后GIB组和无GIB组。在临床随访期间,对格拉斯哥结果评分(GOS)和死亡率进行了评估。研究还调查了诱发因素与GIB之间的相关性:在164名符合条件的患者中,66.5%为男性,平均年龄为(31.38 ± 13.44)岁。严重创伤性脑损伤的发生率较高(p结论:入院时的原发性 GCS 和低血压、脊柱损伤和轴内脑损伤是 TBI 患者发生 GIB 的独立预测因素。根据约 18 个月后的 GOS 评估,创伤性脑损伤患者出现 GIB 与较差的神经功能预后有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Gastrointestinal bleeding following traumatic brain injury: A clinical study on predisposing factors and outcomes.

Background: Traumatic brain injury (TBI) is one of the most common causes of death and disability worldwide. Stress ulcers are common in critically ill patients and can lead to life-threatening gastrointestinal bleeding (GIB). This study investigates the impact of predisposing factors on GIB and outcomes of TBI patients.

Methods: This retrospective cohort study included TBI patients admitted between February 2019 and November 2021. Patients' demographic information and clinical characteristics were collected and divided into Post-TBI GIB and No-GIB groups. During clinical follow-up, the Glasgow Outcome Score (GOS) and mortality were assessed. The correlation between predisposing factors and GIB was investigated.

Results: Out of 164 eligible patients, 66.5% were males, and the mean age was 31.38 ± 13.44 years. There was a higher rate of severe TBIs (p<0.001), intra-axial lesions (P=0.014), hypotension at admission (p<0.001), and concurrent coagulopathies (p<0.001) in the Post-TBI GIB group compared to the No-GIB group. In contrast, the Glasgow Coma Scale (GCS) level upon admission and discharge (p<0.001) and serum hemoglobin level at admission (p<0.001) were lower in the Post-TBI GIB group than in the other group. Moreover, primary GCS (P=0.017) and hypotension at admission (P=0.009), spinal injury (P=0.028), and intra-axial brain injury (P=0.018) were independently associated with GIB in TBI patients.

Conclusion: Primary GCS and hypotension at admission, spinal injury, and intra-axial brain injury are independent predictors for GIB in TBI patients. The presence of GIB in TBI patients is associated with worse neurological outcomes as assessed by GOS at approximately 18 months.

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来源期刊
Caspian Journal of Internal Medicine
Caspian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
1.90
自引率
7.10%
发文量
90
审稿时长
20 weeks
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