乌干达西南部姆巴拉拉地区转诊医院收治的创伤性脑损伤重症监护后患者的预后及其预测因素:一项回顾性研究

Evas Atuhaire, Eric Murungi, Joseph Atukwatse, Vallence Niyonzima, Joseph Namanya, Chris Byaruhanga, Betty Kinkuhaire
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摘要

目的:创伤性脑损伤(TBI)是世界范围内发病率和死亡率的主要原因。乌干达的tbi正在增加,但对icu后患者的预后及其预测因素知之甚少。本研究评估了乌干达西南部姆巴拉拉地区转诊医院(MRRH)收治的重症监护后TBI患者的预后及其预测因素。方法:采用回顾性研究的方法回顾重症监护病房(ICU) MRRH合并TBI患者的住院记录。将数据输入Excel,清洗后导出到Stata版本进行分析,并以均数(标准差)、中位数(四分位间距)和数(百分比)表示,同时使用卡方检验和多项逻辑回归作为icu后结局的预测因子。结果:研究中,男性占73%,81%为工作年龄(15-64岁)。道路交通事故(83%)是最常见的伤害机制,其次是身体伤害(11%)。重症监护病房住院时间为9 (IQR = 4 ~ 8)天,ICU入院和出院时平均GCS分别为7.7(±2.65)和10(±3.27)天。57例(63%)出院回家;在格拉斯哥昏迷结局量表中,73%的患者恢复良好。ICU后的结局与ICU出院时的GCS相关。ICU出院时格拉斯哥昏迷评分中度者出院率是ICU出院时格拉斯哥昏迷评分重度者死亡率的3.59倍(OR=3.59;95%CI, 1.11 ~ 11.63)。本研究确立了GCS作为ICU出院患者预后的统计预测指标。对理论、实践和政策的独特贡献:基于本研究的发现,预防脑外伤是降低脑外伤相关死亡率的关键。政策制定者制定规则,不断向所有道路使用者传授和执行道路安全和交通规则。
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Outcomes and Their Predictors in Post- Intensive Care Patients Admitted With Traumatic Brain Injury at Mbarara Regional Referral Hospital, Southwestern Uganda: A Retrospective Study
Purpose: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide. TBIs are increasing in Uganda, but little is known about outcomes and their predictors in post-ICU patients. This study assessed outcomes and their predictors in post-ICU patients admitted with TBI at Mbarara Regional Referral Hospital (MRRH) in south-western Uganda. Methodology: Retrospective study was used to review hospital records of patients admitted to the Intensive Care Unit (ICU) for MRRH with TBI. Data were entered into Excel, cleaned and exported to Stata version for analysis and presented as mean (standard deviation), median (interquartile range) and number (percent), while using the chi-square test and multinomial logistic regression as predictors for Post-ICU outcomes were used Findings: In the study, males dominated at 73%, while 81% were of working age (15-64 years). Road traffic accidents (83%) were the most common injury mechanism, followed by physical injury at 11%. Length of stay in the Intensive Care Unit was 9 (IQR = 4–8) days, mean GCS at ICU admission and discharge was 7.7 (±2.65) and 10 (±3.27), respectively. Fifty-seven patients (63%) were discharged home; with 73% good recovery Glasgow coma Outcome Scale of hospital discharges. Post-ICU outcomes were associated with GCS at ICU discharge ( . Having moderate Glasgow Coma Scale on ICU discharge was 3.59 times higher of being discharged home than dying compared to severe GCS on ICU discharge (OR=3.59; 95%CI, 1.11 to 11.63). This study established GCS as a statistical predictor of patient outcomes at ICU discharge. Unique Contribution to Theory, Practice and Policy: Based on the findings of this study, prevention of TBI is critical in order to reduce incidence of TBI related mortality. Policy makers to put rules that continuously teach and enforce road safety and traffic rules to all road users.
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