Clinical analysis for 1931 cases of traumatic brain injury in Guizhou Province

Abstract

Objective To summarize the sociodemographic information, injury data, treatment methods and prognosis of patients with traumatic brain injury (TBI) in Guizhou Province, and to explore the treatment ideas of TBI in this area. Methods A total of 1931 patients with TBI who were diagnosed and treated in Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University from January 2016 to December 2018 were recruited by self⁃designed data questionnaire. The clinical data included gender, age, occupation, area of injury, cause of injury, type of injury, location of injury, severity of injury, whether the midline deviated, location of hematoma, combined injury, whether pre⁃hospital first aid, whether surgical treatment, operation time window, postoperative complications and infection during hospitalization. Glasgow Outcome Scale (GOS) was used to evaluate the prognosis of patients. Results According to GOS score, there were 1488 cases (77.06%) with good recovery, 134 cases (6.94%) with mild disability, 101 cases (5.23%) with severe disability, 134 cases (6.94%) with vegetative survival and 74 cases (3.83%) with death. 1) Social demographic data: there were significant differences in GOS scores between different ages (F = 6.411, P = 0.000) and occupations (F = 5.446, P = 0.000). The prognosis of 46-55 years old patients was worse than that of 5-15 years old patients (t = 5.047, P = 0.000). The prognosis of self ⁃ employed workers was worse than that of preschool children (t = ⁃ 3.570, P = 0.021), students (t = ⁃ 5.050, P = 0.000) and cooks (t = ⁃ 3.763, P = 0.013). There was no significant difference in the prognosis between different genders (t = 0.123, P = 0.902). 2) Injury data: there were significant differences in the prognosis among different injury causes (F = 2.585, P = 0.017), injury sites (F = 5.314, P = 0.000) and injury severity (F = 238.321, P = 0.000). The prognosis of traffic injury was worse than that of strike injury (t = ⁃ 3.731, P = 0.004). The prognosis of basal ganglia injury was worse than that of cerebellar injury (t = ⁃ 3.340, P = 0.002). The prognosis of severe (t = 15.983, P = 0.000) and medium (t = 5.711, P = 0.000) patients was worse than that of mild, and severe patients was worse than that of the medium (t = 9.130, P = 0.000). The prognosis of no⁃Guiyang patients was worse than that of patients in Guiyang (t = ⁃ 2.231, P = 0.026). The prognosis of open injury patients was worse than that of closed injury patients (t = ⁃ 3.069, P = 0.002), subdural hematoma patients was worse than that of epidural hematoma patients (t = 4.559, P = 0.000), and the prognosis of patients with midline shift was worse than that of patients without midline shift (t = ⁃ 17.781, P = 0.000). The prognosis of patients with combined injury was worse than that of patients without combined injury (t = ⁃ 4.725, P = 0.000). 3) Treatment and complications: the prognosis of patients with pre⁃hospital first aid was worse than that without pre⁃hospital first aid (t = 4.343, P = 0.000). The prognosis of patients with surgical treatment was worse than that of patients with conservative treatment (t = ⁃ 5.506, P = 0.000). The prognosis of patients with postoperative complications was worse than that of patients without complications (t = ⁃ 15.845, P = 0.000), and the prognosis of patients with concurrent infection during hospitalization was worse than that of patients without infection (t = ⁃ 14.645, P = 0.000). While there was no significant difference in prognosis between CT examination time (t = ⁃ 1.942, P = 0.052) and operation time window (t = ⁃ 1.483, P = 0.140). Conclusions The disability rate of TBI in Guizhou Province is high. Strengthening the propaganda and education of traffic and production safety knowledge can prevent and reduce TBI. Strengthening the professional training of neurosurgeons in county⁃level hospitals can make TBI patients get timely, standardized and homogeneous treatment, and improve the prognosis.

doi：10.3969/j.issn.1672⁃6731.2021.03.012