背景:尽管酒精中毒患者很难评估他们的意识水平并在院前运送,有证据表明,酒精中毒的头部损伤患者的生存结局更好.本研究使用日本创伤数据库(JTDB)评估了酒精中毒的颅脑损伤患者的生存率和脑功能结果是否优于清醒患者。日本全国范围内的创伤登记处.
方法:17,823例钝性外伤患者,包括头部受伤,对2019年1月至2021年12月在JTDB数据库中注册的人进行回顾性分析.对钝性创伤患者的院内生存率进行Logistic回归分析。包括头部受伤的人,根据格拉斯哥预后量表(GOS),仅头部受伤的患者具有良好的脑功能。使用简化损伤量表(AIS)2008或损伤严重程度评分(ISS)类别,比较了饮酒和不饮酒组之间的头部损伤评分的生存率。
结果:饮酒显着影响生存率(比值比1.800,p<0.001)和良好的脑功能(比值比1.546,p<0.001),如使用单独的头部损伤或钝性多部位创伤(包括头部损伤)的逻辑回归分析所示,分别。根据ISS类别或负责人AIS评分的分析,在钝性创伤的存活率方面,饮酒组和非饮酒组在几个类别(ISS9-15、16-24和25-40以及AIS3和5)之间存在显着差异。包括头部受伤,或良好的GOS率与头部受伤。
结论:钝性创伤的存活率,包括头部受伤,饮酒组基于GOS的脑功能预后优于对照组。多变量分析还显示,饮酒与更好的结果显着相关。
BACKGROUND: Although alcohol-intoxicated patients have difficulties evaluating their consciousness level and being transported prehospital, there is some evidence that the survival outcomes for alcohol-intoxicated patients with head injuries are better. The present study evaluated whether the survival and brain function outcomes in alcohol-intoxicated trauma patients with head injuries were better than those in sober patients using the Japan Trauma Data Bank (JTDB), a nationwide trauma registry in Japan.
METHODS: The 17,823 patients with blunt trauma, including head injuries, who were registered in the JTDB database between January 2019 and December 2021 were retrospectively analyzed. Logistic regression analyses were performed for in-hospital survival in patients with blunt trauma, including those with head injuries, and for good brain function based on the Glasgow outcome scale (GOS) in patients with only head injuries. Survival rates by head injury score using the abbreviated injury scale (AIS) 2008 or injury severity score (ISS) categories were compared between drinking and nondrinking groups.
RESULTS: Drinking significantly affected survival (odds ratio 1.800, p<0.001) and good brain function (odds ratio 1.546, p<0.001), as indicated by logistic regression analysis using head injuries alone or blunt multisite trauma (including head injuries), respectively. According to analyses by the ISS category or head AIS score, there were significant differences between the drinking and non-drinking groups in several categories (ISS 9-15, 16-24, and 25-40 and AIS 3 and 5) regarding survival rates with blunt trauma, including head injuries, or good GOS rates with head injuries alone.
CONCLUSIONS: The survival rates for blunt trauma, including head injuries, and the prognosis for brain function based on the GOS were better in the drinking group than in the control group for cases with head injuries alone. A multivariate analysis also showed that alcohol consumption was significantly associated with better outcomes.