老年人坠落受伤致颅脑损伤死亡危险因素分析

摘要

Objective To study 471 cases of severe traumatic brain injury(TBI) retrospectively,analyse the risk factors of mortality, and discuss the impact of falls on cerebral injury in eldly. Methods Dates of 276 patients were collected including age , sex , mechanism of injury , initial Glasgow Coma Score , blood pressure, papillary assessment , CT scan findings, and results of treatment. Results Falls contributed to 21% of all severe TBI, 12% occurring from > 3 meters and 9% from < 3 meters. Two-week mortality was 31% in falls from < 3 meters, 18% in other injuries(P≤0. 0001). Mortality after a severe TBI is higher in elderly than other ages. Mortality was 58% in elderly > 65 years in Falls from < 3 meters. Conclusion Falls from < 3 meters is a key risk factor for elderly > 65 years. Elderly should avoid falls from < 3 meters.%目的探讨坠落方式对老年人颅脑损伤的影响并分析死亡的危险因素.方法 回顾分析我院神经外科1996年1月～2010年12月共471例颅脑损伤患者的年龄、性别、受伤机制、伤后早期GCS评分、血压、瞳孔变化监测和CT扫描结果、治疗结果等数据并按排除标准排除后共有276例患者纳入作统计学分析.结果 276例中21%为坠落伤,其中12%坠落高度＞3m,另外9% ＜3m.伤后2周病死率研究发现,＜3m的坠落伤病死率为31%,其它损伤病死率仅18%.严重颅脑损伤老年患者病死率明显高于其它年龄段.对于≥65岁的老年人坠落高度＜3m,其病死率达58%.结论 在≥65岁的老年人,低空坠落伤是一个严重危险因素.避免≤3m低空伤,对降低老年人颅脑损伤病死率有明显影响.