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首页> 外文期刊>Acta Neurochirurgica >Frequency and characteristics of traumatic brain injury in restrained drivers involved in road traffic accidents
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Frequency and characteristics of traumatic brain injury in restrained drivers involved in road traffic accidents

机译：道路交通事故涉及抑制司机创伤性脑损伤的频率和特征

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Background While seatbelt is an important device protecting drivers from traumatic brain injury (TBI), it has rarely been reported how often and in what circumstances restrained drivers sustain TBI after road traffic accident (RTA). Whole-body computed tomography (WBCT) for blunt trauma patients may provide a unique opportunity to investigate the frequency and characteristics of TBI sustained by restrained drivers. Methods A single-center, retrospective observational study was conducted using prospectively acquired data. Between January 2013 and December 2017, 409 restrained drivers (284 men/125 women, mean age of 45.0?±?19.1?years) whose vehicle had been severely damaged in RTAs underwent WBCT for evaluation of injuries. Multivariate regression analysis was performed to identify variables predictive of TBI. Influence of collision patterns (frontal, lateral or rollover) on the frequency and severity of TBI was evaluated. Relationship between collision patterns and CT findings was also reviewed. Results Thirty-one restrained drivers (7.6%) sustained TBI after RTA. The distribution of Glasgow Coma Scale (GCS) scores among the 31 drivers was 15 in 9, 13–14 in 9, 9–12 in 4, and ≤?8 in 9, indicating that the majority of TBIs were classifiable as mild. The frequency of TBI in alert and oriented drivers, i.e. , those with a GCS score of 15, was 2.9%. Multivariate regression analysis showed that both altered mental status (OR, 4.933; 95% CI, 1.135–21.431) and loss of consciousness (OR, 6.492; 95% CI, 1.669–25.249) were associated with TBI. The frequency of TBI tended to be higher in drivers with rollover collision than those with frontal collision (6 vs. 13%, p ?=?0.07). Interhemispheric acute subdural hematoma and subcortical petechial hemorrhage seemed to be characteristic CT findings in drivers with frontal and lateral collision, respectively. Conclusions The key finding of this study, i.e., that (1) TBI was observed in 7.6% of restrained drivers with severe vehicular damage, may provide useful information to neurosurgeons who take care of RTA victims. The majority of the TBIs were mild without need for neurosurgical intervention. While association may exist between type of collision and type of brain injury, further studies with prospective design are warranted.
机译：背景技术虽然安全带是保护司机免受创伤性脑损伤（TBI）的重要装置，但很少报告频率和在哪些情况下在道路交通事故（RTA）之后抑制TBI的频率和地区。对于钝性创伤患者的全身计算断层扫描（WBCT）可以提供探讨受限制司机维持的TBI频率和特征的独特机会。方法使用预期获取数据进行单中心，回顾性观察研究。 2013年1月至2017年12月期间，409名受限制的司机（284名男性/ 125名女性，平均年龄为45.0岁？进行多元回归分析以识别TBI预测的变量。评估碰撞模式（正面，横向或翻转）对TBI频率和严重程度的影响。还审查了碰撞模式与CT结果之间的关系。结果THITTY-1次受约束的司机（7.6％）RTA后持续TBI。 31例驾驶员之间的Glasgow Coma Scale（GCS）分数在9,13-14中为4，9-12，在4中，≤α8，表明大多数TBIS被视为轻度。警报和面向驾驶员中TBI的频率，即GCS得分为15分，为2.9％。多元回归分析表明，所有改变的精神状态（或4.933; 95％CI，1.135-21.431）和意识丧失（或6.492; 95％CI，1.669-25.249）与TBI有关。 TBI的频率倾向于具有折叠碰撞的驱动器中的频率高于前碰撞（6 vs.13％，p？= 0.07）。卵闭急性硬膜体血肿和皮质削减性出血似乎分别是具有正面和横向碰撞的司机的特征CT调查结果。结论本研究的关键发现，即（1）在7.6％的受限制司机中观察到具有严重车辆损伤的危险障碍，可以为照顾RTA受害者的神经外部提供有用的信息。大多数TBIS都温和，无需神经外科干预。虽然协会可能存在于碰撞类型和脑损伤类型之间，但有必要进行前瞻性设计的进一步研究。

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