老年重型颅脑损伤并发多脏器功能障碍的危险因素  

Risk factors for multiple organ dysfunction in elderly patients with severe traumatic brain injury

作　　者：徐阳 崔慧琴 徐婷 顾仁丽 XU Yang;CUI Hui-qin;XU Ting;GU Ren-li(Department of Trauma Surgery,Hai'an People's Hospital,Hai'an 226600,China;Department of Neurosurgery,Hai'an People's Hospital,Hai'an 226600,China)

机构地区：[1]海安市人民医院创伤外科,江苏226600 [2]海安市人民医院神经外科,江苏226600

出　　处：《中国临床神经外科杂志》2023年第12期705-707,711,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨老年重型颅脑损伤并发多脏器功能障碍(MODS)的危险因素。方法回顾性分析2018年3月至2023年2月收治的156例老年重型颅脑损伤的临床资料。住院期间,参照1995年全国危重病急救医学学术会议标准进行诊断MODS。结果156例中,52例(33.33%)发生MODS。多因素logistic回归分析显示,入院GCS评分低、合并颅内感染、APACHE-Ⅱ评分高、动脉血气PH值下降以及APTT延长是老年重度颅脑损伤发生MODS的独立危险因素。ROC曲线分析回归模型预测老年重型颅脑损伤发生MODS的曲线下面积为0.93(95%CI:0.87~0.96),敏感性为84.62%(95%CI:71.9%~93.1%),特异性为95.19%(95%CI:89.1%~98.4%)。结论MODS是老年重型颅脑损伤常见并发症。本文构建的回归模型对MODS具有一定预测作用。Objective To investigate the risk factors for multiple organ dysfunction(MODS)in elderly patients(≥60 years)with severe traumatic brain injury(sTBI).Methods The clinical data of 156 elderly patients with sTBI treated from March 2018 to February 2023 were retrospectively analyzed.During hospitalization,MODS were diagnosed according to the criteria of the 1995 National Conference on Critical Care and Emergency Medicine.Results Of these 156 patients,52 patients(33.33%)suffered from MODS.Multivariate logistic regression analysis showed that low admission GCS score,intracranial infection,high APACHE-Ⅱscore,decreased arterial blood PH and prolonged APTT were independent risk factors for MODS in the elderly patients with sTBI.ROC curve analysis showed that the area under the curve of the regression model constructed based on the above risk factors predicting MODS in the elderly patients with sTBI was 0.93(95%CI:0.87~0.96),the sensitivity was 84.62%(95%CI:71.9%~93.1%),and the specificity was 95.19%(95%CI:89.1%~98.4%).Conclusions MODS is a common complication of elderly patients with sTBI.The regression model constructed in this paper can predict MODS to some extent.

关 键 词：重型颅脑损伤 老年人 多脏器功能障碍 危险因素 

分 类 号：R651.15[医药卫生—外科学]