目的:为了确定和比较灵敏度,特异性,根据脑损伤指南和轻度TBI风险评分,轻度创伤性脑损伤和并发颅内损伤患者符合出院条件的患者比例。
方法:回顾性回顾2014/01/01和2019/12/31之间在赫尔辛堡医院寻求治疗的创伤性颅内损伤和初始格拉斯哥昏迷量表评分为14-15的成年患者的医疗记录。这两个准则在理论上都适用。敏感性,特异性,并计算了理论上可以根据任一指南出院的队列百分比.结果被定义为死亡,医院干预,入住重症监护室,由于颅内损伤需要紧急插管,意识下降,或在陈述后30天内癫痫发作。
结果:在538例患者中,根据脑损伤指南和轻度TBI风险评分,8例(1.5%)和10例(1.9%)符合出院条件。分别。两项指南的灵敏度均为100%。脑损伤指南的特异性为2.3%,轻度TBI风险评分的特异性为2.9%。
结论:两个指南的敏感性没有差异,特异性,或符合出院条件的队列比例。符合出院条件的队列的特异性和比例低于每个指南的原始研究。目前,在当前或类似设置中,都不建议实施任何指南。
OBJECTIVE: To determine and compare the sensitivity, specificity, and proportion of patients eligible for discharge by the Brain Injury Guidelines and the Mild TBI Risk Score in patients with mild traumatic brain injury and concomitant intracranial injury.
METHODS: Retrospective review of the medical records of adult patients with traumatic intracranial injuries and an initial Glasgow Coma Scale score of 14-15, who sought care at Helsingborg Hospital between 2014/01/01 and 2019/12/31. Both
guidelines were theoretically applied. The sensitivity, specificity, and percentage of the cohort that theoretically could have been discharged by either
guideline were calculated. The outcome was defined as death, in-hospital intervention, admission to the intensive care unit, requiring emergency intubation due to intracranial injury, decreased consciousness, or seizure within 30 days of presentation.
RESULTS: Of the 538 patients included, 8 (1.5%) and 10 (1.9%) were eligible for discharge according to the Brain Injury Guidelines and the Mild TBI Risk Score, respectively. Both
guidelines had a sensitivity of 100%. The Brain Injury Guidelines had a specificity of 2.3% and the Mild TBI Risk Score had a specificity of 2.9%.
CONCLUSIONS: There was no difference between the two guidelines in sensitivity, specificity, or proportion of the cohort eligible for discharge. Specificity and proportion of cohort eligible for discharge were lower than each
guideline\'s original study. At present, neither
guideline can be recommended for implementation in the current or similar settings.