Clinical characteristics and outcomes in patients with traumatic brain injury in China: a prospective, multicentre, longitudinal, observational study

Abstract

BackgroundLarge scale collaborations are required to generate clinical evidence of traumatic brain injury (TBI) treatments. Current evidence is limited and mostly originates from western countries. China has a potential to generate strong evidence, but uncertainty exists how comparable the baseline, treatment and outcome is to other settings. We aimed to document the current care for TBI and its outcome in China by conducting a prospective, multicentre Chinese TBI registry. Methods This prospective, multi-centre, longitudinal, observational study was conducted in 56 centres across China. It collected data of hospitalized patients with a clinical diagnosis of TBI and indication for computerized tomography (CT) scanning. The primary endpoint was survival on discharge. Prognostic analyses were applied to identify predictors of mortality. Variations in mortality were compared between centres and regions within China. Mortality was compared to expected mortality estimated by CRASH basic model. The study was registered with ClinicalTrials.gov, number NCT02210221. Findings From 22nd, Dec, 2014, to 1st, Aug, 2017, 13627 patients with TBI from 56 centers were enrolled in the China CENTER-TBI registry. Data of 13138 patients from 52 hospitals in 22 provinces of China were analyzed. Most patients were male (9782 [74%]), with a median age of 48 (IQR: 33-61). The median Glasgow Coma Scale (GCS) was 13 (IQR: 9-15) and major cause (6548 [50%]) of injury was traffic incident. Overall hospital mortality was 4.8% (637), and in severe TBI 19.7% (552). Age, GCS, Injury Severity Score, pupillary reflex, CT findings, hypoxia and hypotension showed predictive value for mortality. Economic level and altitude of the regions were correlated significantly with death. Variation in mortality existed between centres or regions. The observed mortality was lower than expected (O/E ratio 0•49, 95% CI 0•45-0•53). Interpretation The results show differences in mortality between centres and regions, which indicates potential for identifying best practices in comparative effectiveness research. The risk Powered by Edit orial Manager® and ProduXion Manager® from Aries Syst em s Corporat ion Clinical characteristics and outcomes in patients with traumatic brain injury in China: a prospective, multicentre, longitudinal, observational study

Một Số Đặc Điểm Dịch Tễ Học Bệnh Nhân Chấn Thương Sọ Não Tại Bệnh Viện Việt Đức

“…Chấn thương sọ não là một nguyên nhân chính gây ra bệnh tật và tử vong ở Việt Nam và các nước khác trên thế giới 1,2 . CTSN cũng là nguyên nhân hàng đầu gây tử vong ở thanh thiếu niên và gây ra tàn tật và thiệt hại kinh tế liên quan đến sức khỏe 3 .…”

“…Thêm vào đó theo nhiều nhiên cứu trong và ngoài nước nguyên nhân chủ yếu gây ra CTSN là tai nạn giao thông và có liên quan tới rượu bia 2,5…”

“…Trong tổng sô 1002 bệnh nhân chúng tôi có số lượng bệnh nhân nam cao gấp khoảng 3.7 lần bệnh nhân nữ. Đặc điểm dịch tễ này được hầu hết các tác giả ghi nhận ở các nghiên cứu khác 2,4,6 . Điều này có thể giải thích bởi nam giới là đối tượng chủ yếu tham gia giao thông cũng như lao động sản suất.…”

Controlled decompression alleviates early brain injury in rabbit intracranial hypertension model by regulating apoptosis/necroptosis

“…Severe traumatic brain injury (sTBI) is a common condition in neurosurgery. According to the epidemiological statistics, the incidence of sTBI is considerably high, which can account for about 10–20% of the total number of surgical traumas, and has a higher wartime incidence 1 , 2 . The increased intracranial pressure (ICP) is one of the main causes of death after sTBI 3 , 4 .…”

Tittle Exploring the Mechanism of Resveratrol on Traumatic Brain Injury by Network Pharmacology and Molecular Docking

“…Traumatic brain injury (TBI) refers to damage to the brain caused by a violent force applied directly or indirectly to the head [1] . Because TBI often leads to complications such as infection, limb motor dysfunction, brain nerve dysfunction, and systemic organ dysfunction, the mortality rate of TBI in China is as high as 7% [2] . The pathological mechanism of TBI is complicated, and there is no effective treatment for TBI in the clinic.…”