院前和急诊室环境中的头部损伤:法国一项前瞻性多中心横断面研究。

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE
Xavier Dubucs, Thomas Lafon, Romain Adam, Solene Loth, Flore Tabaka, Florian Negrello, Mustapha Sebbane, Valerie Boucher, Eric Mercier, Marcel Émond, Sandrine Charpentier, Frederic Balen
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引用次数: 0

摘要

背景:头部受伤是急诊科(ED)创伤的主要原因。最近的研究表明,急诊科头部受伤患者的流行病学发生了变化。本研究的主要目的是描述在法国急诊室就诊的头部外伤患者的概况,并评估 i) 不同年龄组的头部外伤严重程度;ii) 头部外伤发生与急诊室到达之间的延迟时间;iii) 与外伤性颅内出血(ICH)相关的因素:这项横断面研究收集了 2023 年 3 月为期三天的患者数据。所有因头部受伤(定义为头部外伤)而入住急诊室的成年患者(≥ 18 岁)均被纳入研究范围。创伤性脑损伤的严重程度根据患者在急诊室的格拉斯哥昏迷量表初始评分进行分类:重度(3-8分);中度(9-12分);轻度(13-15分);无短暂或持续神经症状的单纯头部外伤:在参与研究的 71 家急诊室中,共有 26 008 名患者到急诊室就诊,其中 1070 名患者(4.1%,IC 95 3.9-4.4)出现头部外伤,中位年龄为 68.5 [37-85] 岁。大多数患者(66.7%)是在向紧急医疗调度员(EMD)求助后被转诊至急诊室的。从头部受伤到急诊室就诊的中位时间为 2 小时 [1.0 - 5.5]。地面跌落是头部受伤的主要原因(60.3%)。大多数患者为单纯性头部外伤(715 人,66.8%),其次为轻度创伤性脑损伤(337 人,31.5%)。对 636 名患者(59.6%)进行了头部 CT 扫描,其中 58 人呈阳性。创伤性 ICH 发生率为 5.4% (95% CI: 4.1-6.9),3 名患者(0.3%)需要紧急神经外科干预。受伤前使用抗凝剂(p = 0.97)或抗血小板(p = 0.93)均与外伤性 ICH 风险增加无关:结论:在急诊室就诊的头部外伤患者中,每两人中就有一人年龄超过65岁。由急诊科转诊的患者更有可能及时到急诊科就诊。大多数老年患者接受了头部 CT 扫描,受伤前使用抗凝剂与外伤性 ICH 风险增加无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Head injuries in prehospital and Emergency Department settings: a prospective multicenter cross-sectional study in France.

Background: Head injuries are the leading cause of trauma in Emergency Departments (EDs). Recent studies have shown epidemiological changes in patients consulting ED for head injuries. The main objective of this study was to describe the profile of head injury patients consulting in the EDs in France and assess i) head injury severity across age groups; ii) the delay between the occurrence of head injury and ED arrival; iii) factors associated with traumatic intracranial hemorrhage (ICH).

Methods: This cross-sectional study collected patient data over a three-day period in March 2023. All adult patients (≥ 18 years old) admitted to the ED with a head injury (defined as a trauma to the head) were included. TBI severity was classified according to patients' initial Glasgow Coma Scale score in the ED: severe (3-8); moderate (9 -12); mild (13-15); and simple head trauma in the absence of transient or persistent neurological symptoms.

Results: Among the 71 participating EDs, 26,008 patients visited EDs and a total of 1070 patients (4.1%, IC 95 3.9-4.4) presented a head injury were included in the study, with a median age of 68.5 [37-85] years old. Most of the patients (66.7%) were referred to ED after a call to the Emergency Medical Dispatcher (EMD). The median time from head injury to ED visit was 2 h [1.0 - 5.5]. Ground-level falls were the leading cause of head injury (60.3%). Most of patient presented a simple head trauma (n = 715, 66.8%) followed by mild TBI (n = 337, 31.5%). CT head scans were performed for 636 patients (59.6%), of which 58 were positive. Traumatic ICH prevalence was 5.4% (95% CI: 4.1-6.9) and three patients (0.3%) required an urgent neurosurgical intervention. Neither preinjury anticoagulant (p = 0.97) nor antiplatelet (p = 0.93) use was associated with an increased risk of traumatic ICH.

Conclusions: One head injury patient out of two presenting in the ED is aged over 65 years. Patients referred by EMD were more likely to visit ED promptly. The majority of older patients underwent a head CT scan and preinjury anticoagulant use was not associated with increased risk of traumatic ICH.

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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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