老年人重型颅脑外伤预后相关因素分析

Analysis on the related factors of prognosis of severe traumatic brain injure in elderly patients

目的探讨影响老年人重型颅脑外伤预后的相关因素。方法回顾性分析1993年1月至2008年12月华东医院神经外科诊治的164例老年重型颅脑外伤患者的临床资料，分析各项临床㈨素与预后的关系。应用统计软件进行单因素分析和多闵素Logistic叫归分析。结果1．本组死亡99例，死亡率为60．4％；生存65例，其中恢复良好12例，轻中残18例，重残28例，植物生存7例；2．统计分析显示，格拉斯哥昏迷评分（GCS）、伤后24h血糖、典型CT图像、慢性阻塞性肺部疾病（COPD）、肺部感染是影响预后的主要因素。结论老年重型颅脑外伤（TBI）患者死亡率高，预后差。年龄、GCS评分、伤后24h血糖、典型CT图像、COPD病史、肺部感染等指标是判断预后的重要因素。

Objective To explore the related factors that affect the outcome in elderly patients with severe traumatic brain injury. Methods We retrospectively analyzed the clinical features of 164 aged patients with severe traumatic brain in- jury treated in our hospital from January 1993 to December 2008. Univariate analysis and multivariate logistic regression analysis were used to evaluate the relationship between related factors and prognosis. Results Of 65 survived, 12 were with good recovery, 18 moderately disabled, 28 severely disabled, 7 was in a persistent vegetative state and 99 died. The mortality was 60.4%. Multivariate analysis identified that advanced age, GCS, blood sugar, characteristically image of CT scan, history of COPD, pulmonary infection were the significant factors of prognosis. Conclusions Elderly patients with severe traumatic brain injury have a high mortality and poor outcome. Prognosis of elderly patients determined by age, GCS, blood sugar, characteristical image of CT scan, history of COPD, pulmonary infection.