■为了识别和描述人口统计学的差异,损伤特征,以及农村和城市脑损伤患者之间的结果。
■CINAHL,Emcare,MEDLINE,还有Scopus.
■根据PRISMA和MOOSE指南,对比较农村和城市脑外伤的流行病学和结局的研究进行了系统评价和荟萃分析。
■36项研究纳入了约250万患者。男性脑损伤发生率较高,无论地点。与运输有关的脑损伤的比率,特别是涉及汽车以外的机动车辆,在农村人口中明显更高(OR:3.63,95%CI[1.58,8.35],p=0.002),而城市居民有更多的跌倒性脑损伤(OR:0.73,95%CI[0.66,0.81],p<0.00001)。农村患者遭受严重伤害的可能性增加了28%,格拉斯哥昏迷量表(GCS)≤8(OR:1.28,95%CI[1.04,1.58],p=0.02)。死亡率无差异(OR:1.09,95%CI[0.73,1.61],p=0.067),然而,城市患者出院的可能性是预后良好的两倍(OR:0.52,95%CI[0.41,0.67],p<0.00001)。
■农村与创伤性脑损伤的严重程度和预后较差相关。交通事故不成比例地影响那些在农村道路上行驶的人。未来的研究建议包括增加院前数据,充分的后续行动,标准化措施,和高危人群的亚组分析,例如土著居民。
UNASSIGNED: To identify and describe differences in demographics, injury characteristics, and outcomes between
rural and urban patients suffering brain injury.
UNASSIGNED: CINAHL, Emcare, MEDLINE, and Scopus.
UNASSIGNED: A systematic
review and meta-analysis of studies comparing epidemiology and outcomes of
rural and urban brain trauma was conducted in accordance with PRISMA and MOOSE guidelines.
UNASSIGNED: 36 studies with ~ 2.5-million patients were included. Incidence of brain injury was higher in males, regardless of location. Rates of transport-related brain injuries, particularly involving motorized vehicles other than cars, were significantly higher in rural populations (OR:3.63, 95% CI[1.58,8.35], p = 0.002), whereas urban residents had more fall-induced brain trauma (OR:0.73, 95% CI[0.66,0.81], p < 0.00001).
Rural patients were 28% more likely to suffer severe injury, indicated by Glasgow Coma Scale (GCS)≤8 (OR:1.28, 95% CI[1.04,1.58], p = 0.02). There was no difference in mortality (OR:1.09, 95% CI[0.73,1.61], p = 0.067), however, urban patients were twice as likely to be discharged with a good outcome (OR:0.52, 95% CI[0.41,0.67], p < 0.00001).
UNASSIGNED: Rurality is associated with greater severity and poorer outcomes of traumatic brain injury. Transport accidents disproportionally affect those traveling on
rural roads. Future research recommendations include addition of prehospital data, adequate follow-up, standardized measures, and sub-group analyses of high-risk groups, e.g. Indigenous populations.