老年重型颅脑损伤临床预后的影响因素

Factors influencing prognosis for severe craniocerebral injuries in aged

目的探讨老年重型颅脑损伤临床预后的影响因素。方法 2007年1月—2012年12月,88例老年重型颅脑损伤患者在我科进行诊治,采用单因素、多因素分析对这88例患者的临床资料进行统计学分析。结果术后随访时,死亡46例(52.3%),仍存活的42例(47.7%)。据格拉斯哥预后分级标准,GOS有效率为45.5%。单因素分析发现分别按年龄、GCS评分、合并伤、受伤后的入院时间、血肿类型、合并症分组,各组间的GOS有效率比较,差异均有统计学意义(P<0.01)。采用COX模型进行多因素分析,GCS评分、年龄、受伤后的入院时间、血肿类型及合并症是影响老年重型颅脑损伤预后的重要因素,差异均有统计学意义(P<0.01)。结论 GCS评分、年龄、受伤后的入院时间、血肿类型及合并症是影响老年重型颅脑损伤预后的重要因素。

Objective To investigate the factors influencing prognosis for severe craniocerebral injuries in aged.Methods From January 2007 to December 2012, eighty-eight cases with severe craniocerebral injuries in aged were treated in our department, univariate analysis and multi-factor statistic analysis were used to analyze the clinical data of those eighty-eight patients. Results At follow up, forty-six patients （52. 3% ） died and forty-two cases （47.7%） still alive. Univariate analysis showed that all cases were grouped according to age, GCS score, associated injuries, admission time after injury, hematoma type, comorbidities respectively, and the differences of GOS efficiency between groups were statistically significant （P 〈 0. 01 ）. COX regression model for multivariate analysis showed GCS score, age, admission time after the injury, hematoma type and comorbidities were important factors of clinical prognosis for severe craniocerebral injuries in aged. Conclusion GCS score, age, admission time after the injury, hematoma type and comorbidities were important influencing factors of clinical prognosis for severe craniocerebral injuries in aged.