目的：通过总结、分析颅脑外伤合并多发伤患者的临床资料，评估颅脑外伤合并多发伤患者发生高额住院费用的危险因素。方法：回顾性分析我院颅脑外伤合并多发伤患者的临床资料，查询住院费用，通过卡方检验筛选发生高额费用的危险因素，经多因素Logistic回归分析确定独立危险因素。结果：出院结算时发生高额费用90例（35.29%）。Pearson卡方检验显示入院时AIS-ISS评分、GCS评分、全身麻醉手术治疗、机械通气、肺部感染、泌尿系感染、腹泻、吸烟史等因素与发生高额费用相关性差异有统计学意义(P＜0.05)，Logistic回归多因素分析显示入院时AIS-ISS评分、全身麻醉手术治疗、肺部感染、泌尿系感染、吸烟史等因素为颅脑外伤合并多发伤患者发生高额费用的独立危险因素。结论：对于颅脑外伤合并多发伤患者，应在全面评估伤情基础上明确手术指征，并且积极预防感染，从而降低患者发生高额医疗费用的风险。%To summarize the clinical parameters of patients with traumatic brain injury combined multiple trauma and evaluate risk factors of high cost in hospital. Methods: The clinical data of patients suffering traumatic brain injury combined multiple trauma in our institution were analyzed retrospectively. Chi-square test was used to select risk factors for high cost. Non-condition logistic regression analysis was used to define the independent risk factors. Results: There were 90 (35.29%) cases with high cost at discharge. Factors including AIS-ISS and GCS score on admission, operation under general anesthesia, mechanical ventilation, peumonia, urinary infections, diarrhea and smoking were revealed as the factors significantly related to high cost by Pearson chi-square test. Then, AIS-ISS score on admission (OR=15.842, 95%CI 4.375-57.355,P<0.01), operation under general anesthesia (OR=7.946,95%CI 2.262-27.919,P<0.01), pneumonia (OR=28.552,95%CI 8.771-92.943,P<0.01), urinary infections (OR=3.690,95%CI 1.225-11.119,P<0.05)and smoking (OR=3.970,95%CI 1.334-11.819,P<0.05)were shown as independent risk factors were shown as statistical significance by the non-condition logistic regression analysis. Conclusion Reasonable operation under the comprehensive evaluation of injure, active prevention of infection for patients with traumatic brain injury combined multiple traumas play important role in decreasing the risk of high cost in hospital.
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