Surgical treatment of elderly patients with the moderate-severe traumatic brain injury
10.3969/j.issn.1005-6483.2024.07.008
- VernacularTitle:老年中重型创伤性颅内血肿的手术治疗
- Author:
Hui YANG
1
;
Xueyan WAN
Author Information
1. 433300 湖北省监利市人民医院(三峡大学附属监利医院)神经外科
- Keywords:
elderly;
traumatic intracranial hematoma;
surgery
- From:
Journal of Clinical Surgery
2024;32(7):697-700
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy and postoperative complications of surgical treatment for middle-aged and severe elderly patients with traumatic intracranial hematoma.Methods A retrospective analysis was conducted on the clinical data,efficacy,and postoperative complications of 80 elderly patients with traumatic intracranial hematoma who underwent surgical treatment at the Neurosurgery Department of Jianli People's Hospital from January 2021 to November 2023.The Glasgow Outcome Scale was used to evaluate their clinical prognosis,and they were divided into a good prognosis group and a poor prognosis group based on their scores.Univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors related to poor prognosis,and compared with the expected prognosis calculated by the International Clinical Trial Study on Brain Injury Prognosis(IMPACT)model to evaluate the therapeutic effect of the surgery.Results Among 80 patients aged 60 and above who underwent surgery for moderate to severe traumatic intracranial hematoma,46(57.5％)had a good prognosis after 6 months of follow-up,34(42.5％)had a poor prognosis,and 13(16.25％)died.The expected poor prognosis rate was calculated to be 63.8％by using the IMPACT experimental core model,and the expected mortality rate was 46.6％.The actual prognosis was better than the expected one.The difference between the actual and expected prognosis and the actual and expected mortality was statistically significant(P＜0.05).Univariate analysis suggests that patient's pupil response,preoperative GCS score,hematoma location,cisternaambiens status,midline displacement,and hematoma size are correlated with patient prognosis.Multivariate analysis suggests that the status of the cisternaambiens is an independent risk factor for poor prognosis in elderly patients with moderate to severe traumatic brain injury.Conclusion Elderly patients with traumatic intracranial hematoma who have surgical indications should be treated with surgery,and the results of aggressive treatment are good.The failure to correct intracranial hypertension in postoperative patients is the main cause of death.
