Investigation of clinical characteristics and death-related factors of non-firarms open head injury

doi:10.3877/cma.j.issn.2095-9141.2021.03.005

Abstract

Abstract:

Objective

To investigate the clinical characteristics and death-related factors of patients with non-firearms open head injury.

Methods

The clinical data of 146 patients with non-firearms open head injury admitted to the Neurosurgery ICU of the First Affiliated Hospital, Air Force Military Medical University from January 2011 to December 2019 were retrospectively analyzed. According to the prognosis of disease, the patients were divided into death group (20 cases) and non-death group (126 cases). The clinical data of the two groups were compared within 24 h in the Neurosurgical ICU to explore the relevant factors affecting the death of patients.

Results

Univariate analysis showed that injury factors, degree of injury, cerebral hernia, coagulation dysfunction, mean arterial pressure <90 mmHg (1 mmHg=0.133 kPa) and admission GCS score were related to the death of patients with non-firearms open head injury; Binary Logistic regression analysis showed that the severity of injury, cerebral hernia and mean arterial pressure <90 mmHg were the independent factors influencing the death of patients with non-firearms open head injury.

Conclusion

Non-firearms open head injury has its unique clinical characteristics, and its mortality was related to the degree of head injury, cerebral hernia and mean arterial pressure less than 90 mmHg.

Key words: Non-firearms open head injury, Cerebral hernia, Mean arterial pressure

Yu Huan, Shijie Hu, Shuang Wu, Xiuquan Wu, Xin He, Yanwei Chen, Wei Du, Zhou Fei, Bing Li. Investigation of clinical characteristics and death-related factors of non-firarms open head injury[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(03): 146-150.

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References 18

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资料		数据
男性[例(%)]		126(86.3)
年龄[M(P₂₅，P₇₅)，岁]		43.0(29.0,53.0)
致伤因素[例(%)]
	坠落伤	29(19.9)
	打击伤	8(5.5)
	车祸伤	72(49.3)
	其他	37(25.3)
损伤程度[例(%)]
	中型	14(9.6)
	重型	75(51.4)
	特重型	57(39.0)
入院GCS评分[M(P₂₅，P₇₅)，分]		6.0(3.0,8.0)
损伤部位[例(%)]
	单纯颅底损伤	70(47.9)
	单纯颅顶损伤	26(17.8)
	颅顶颅底复合损伤	50(34.2)
入院收缩压（±s，mmHg）		131.51±21.42
入院血糖[M(P₂₅，P₇₅)，mmol/L]		8.4(6.9,10.7)
心率[M(P₂₅，P₇₅)，次]		88.0(78.0,110.0)
多发伤[例(%)]		85(58.2)
颅内异物[例(%)]		5(3.4)
脑疝[例(%)]		44(30.1)
ICU时长[M(P₂₅，P₇₅)，d]		11.0(4.5,20.0)

资料		数据
男性[例(%)]		126(86.3)
年龄[M(P₂₅，P₇₅)，岁]		43.0(29.0,53.0)
致伤因素[例(%)]
	坠落伤	29(19.9)
	打击伤	8(5.5)
	车祸伤	72(49.3)
	其他	37(25.3)
损伤程度[例(%)]
	中型	14(9.6)
	重型	75(51.4)
	特重型	57(39.0)
入院GCS评分[M(P₂₅，P₇₅)，分]		6.0(3.0,8.0)
损伤部位[例(%)]
	单纯颅底损伤	70(47.9)
	单纯颅顶损伤	26(17.8)
	颅顶颅底复合损伤	50(34.2)
入院收缩压（±s，mmHg）		131.51±21.42
入院血糖[M(P₂₅，P₇₅)，mmol/L]		8.4(6.9,10.7)
心率[M(P₂₅，P₇₅)，次]		88.0(78.0,110.0)
多发伤[例(%)]		85(58.2)
颅内异物[例(%)]		5(3.4)
脑疝[例(%)]		44(30.1)
ICU时长[M(P₂₅，P₇₅)，d]		11.0(4.5,20.0)

临床特征		死亡组(n=20)	非死亡组(n=126)	t/U/χ²值	P值
年龄（±s，岁）		47.90±4.61	41.28±1.31	1.768	0.096
男性[例(%)]		17(85.0)	109(86.5)	0.033	0.855
致伤因素[例(%)]				8.149	0.043
	车祸伤	10(50.0)	62(49.2)
	打击伤	1(5.0)	7(5.6)
	坠落伤	0(0.0)	29(23.0)
	其他	9(45.0)	28(22.2)
多发伤[例(%)]		12(60.0)	73(57.9)	0.030	0.862
合并胸肺损伤[例(%)]		9(45.0)	53(42.1)	0.061	0.805
损伤部位[例(%)]				4.574	0.102
	单纯颅底损伤	6(30.0)	64(50.8)
	单纯颅顶损伤	3(15.0)	23(18.3)
	颅顶颅底复合损伤	11(55.0)	39(31.0)
损伤程度[例(%)]				20.768	<0.001
	中型	1(5.0)	13(10.3)
	重型	2(10.0)	73(57.9)
	特重型	17(85.0)	40(31.7)
颅内异物[例(%)]		1(5.0)	4(3.2)	0.174	0.677
脑疝[例(%)]		15(75.0)	29(23.0)	22.153	<0.001
凝血功能异常[例(%)]		6(30.0)	14(11.1)	5.209	0.022
平均动脉压<90 mmHg[例(%)]		5(25.0)	8(6.3)	7.402	0.007
入院GCS评分[M(P₂₅，P₇₅)，分]		3.0(3.0,4.0)	6.0(3.0,8.0)	451.000	<0.001

临床特征		死亡组(n=20)	非死亡组(n=126)	t/U/χ²值	P值
年龄（±s，岁）		47.90±4.61	41.28±1.31	1.768	0.096
男性[例(%)]		17(85.0)	109(86.5)	0.033	0.855
致伤因素[例(%)]				8.149	0.043
	车祸伤	10(50.0)	62(49.2)
	打击伤	1(5.0)	7(5.6)
	坠落伤	0(0.0)	29(23.0)
	其他	9(45.0)	28(22.2)
多发伤[例(%)]		12(60.0)	73(57.9)	0.030	0.862
合并胸肺损伤[例(%)]		9(45.0)	53(42.1)	0.061	0.805
损伤部位[例(%)]				4.574	0.102
	单纯颅底损伤	6(30.0)	64(50.8)
	单纯颅顶损伤	3(15.0)	23(18.3)
	颅顶颅底复合损伤	11(55.0)	39(31.0)
损伤程度[例(%)]				20.768	<0.001
	中型	1(5.0)	13(10.3)
	重型	2(10.0)	73(57.9)
	特重型	17(85.0)	40(31.7)
颅内异物[例(%)]		1(5.0)	4(3.2)	0.174	0.677
脑疝[例(%)]		15(75.0)	29(23.0)	22.153	<0.001
凝血功能异常[例(%)]		6(30.0)	14(11.1)	5.209	0.022
平均动脉压<90 mmHg[例(%)]		5(25.0)	8(6.3)	7.402	0.007
入院GCS评分[M(P₂₅，P₇₅)，分]		3.0(3.0,4.0)	6.0(3.0,8.0)	451.000	<0.001

因子		偏回归系数	标准误	Wald值	OR(95%CI)	P值
颅脑损伤程度
	中型				1
	重型	0.814	1.213	0.451	2.258(0.210～24.336)	0.502
	特重型	2.153	0.926	5.408	8.615(1.403～52.907)	0.020
脑疝
	是				1
	否	-1.858	0.757	6.025	0.156(0.035～0.688)	0.014
平均动脉压<90 mmHg
	是				1
	否	-2.279	0.959	5.645	0.102(0.016～0.671)	0.018
致伤因素
	坠落伤				1
	打击伤	21.252	6397.750	0.000	0.000	0.997
	车祸伤	3.166	1.628	3.781	23.707(0.975～576.347)	0.052
	其他	1.205	0.666	3.274	3.335(0.905～12.297)	0.070

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