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首页> 外文期刊>Annals of epidemiology >Effect measure modification and confounding of severe head injury mortality by age and multiple organ injury severity.
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Effect measure modification and confounding of severe head injury mortality by age and multiple organ injury severity.

机译：根据年龄和多器官损伤的严重程度，对严重的颅脑损伤死亡率进行修正和混淆。

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PURPOSE: The study aim is to assess confounding and effect measure modification of the relationship between head injury severity (measured using the Glasgow Coma Scale [GCS]) and mortality by age and multiple organ injury (measured using the Injury Severity Score [ISS]). Head injury-related mortality is affected by head injury severity, as well as age and multiple organ injury. However, little is known about the effect modification of these relationships. METHODS: Stratifications and multiple logistic regression analyses examined the association of mortality with GCS score less than 9, controlled for ISS of 16 and higher or age of 55 years and older. Receiver operating curve (ROC) analyses were used to explore the relationship of GCS cutoff values and prediction of death by the ISS and age categories mentioned. RESULTS: Both age and ISS modified head injury mortality in a similar direction: there was a negative interaction between age and ISS and more severe head injury. Lower GCS values (indicating more severe head injury) related more strongly to mortality in younger persons. Lower GCS values related more strongly to mortality when extracranial injuries were less severe. These data indicate effect modification. Data indicate negative confounding of the association between GCS and mortality by age and positive confounding by ISS. Multivariate analyses indicate that only younger age modifies the effect of more severe head injury with statistical significance when both age and multiple organ injury are considered. ROC analyses conducted with stratified and logistic regression analyses indicate that GCS is a better predictor of death in those with younger age. CONCLUSIONS: The relationship of head injury severity and mortality is modified and confounded by age and ISS. GCS is a better predictor of death in younger patients.
机译：目的：研究目的是评估年龄和多器官损伤（使用损伤严重度评分[ISS]测量）对颅脑损伤严重程度（使用格拉斯哥昏迷量表[GCS]测量）与死亡率之间的关系的混淆和影响度量的修改。颅脑损伤相关死亡率受颅脑损伤严重程度以及年龄和多器官损伤的影响。但是，对这些关系的效果修改知之甚少。方法：分层和多元逻辑回归分析检查了死亡率与GCS得分小于9的相关性，其中GCS得分控制在ISS为16及更高或55岁及以上的年龄。接收者工作曲线（ROC）分析用于探讨GCS临界值与国际空间站（ISS）和上述年龄类别的死亡预测之间的关系。结果：年龄和ISS均以相似的方向改变了颅脑损伤的死亡率：年龄与ISS之间存在负相关关系，而颅脑损伤更为严重。较低的GCS值（表明更严重的颅脑损伤）与年轻人的死亡率更密切相关。当颅外损伤不太严重时，较低的GCS值与死亡率更密切相关。这些数据表明效果改变。数据表明，按年龄分列的GCS与死亡率之间存在关联的负混淆，而由ISS表示正混淆。多变量分析表明，当同时考虑年龄和多器官损伤时，只有年龄较小的患者才能对更严重的头部损伤产生影响，具有统计学意义。通过分层和逻辑回归分析进行的ROC分析表明，GCS是年龄较小者中更好的死亡预测指标。结论：颅脑损伤严重程度与死亡率之间的关系因年龄和国际ISS而被修改和混淆。 GCS是年轻患者死亡的更好预测指标。

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