| Objective: This study was designed to analyse the clinical information of TBI inpatients in Tianjin Medical University General Hospital based on the established database of TBI inpatients in this hospital.The epidemiological characteristics,the causes and mechanisms of injury and the other important clinical parameters of them were collected and analyzed in order to provide basic data reference for improving the therapeutic efficiency of TBI.Methods: Based on the Statistical Analysis Database,all the basic data of the inpatients of TBI in Tianjin Medical University General Hospital from January 2011 to December 2016 were collected.The epidemiological were all collected and analyzed.The SPSS statistical software was applied for data processing.The count data was expressed as a percentage and chi-square test was applied to compare the difference between the rates.P <0.05 was recogonized as the statistically significant.Result:1.Age and sex distribution:A total of 2368 patients were included,of which the number of the patients aged 30-60 years old was 1354,the one aged 31-40 was 426,the one aged 41-50,51-60 years old 438.But less than 60 years old,the male to female ratio is: 3.18: 1;more than 60 years of age,male to female ratio is: 2.09: 1.the proportion of male and female casualties were analyzed,the results show that more than 60 years old group,the proportion of women was lower than that of the 60-year-old group,and the difference was statistically significant(P = 0.002).2.Causes and Mechanisms of Injury:A total of 1424 cases were injured in the traffic accidents,so the traffic accidents ranked the first injured cause.The second injured cause was fall with 323 inpatientsfalled in the ground and 178 ones falled from high altitude.Other 175 ones were injured by attacking(7.39%)and the causes of the other 128 patients were not recorded.Further analysis could subgroup the traffic injury as the car accident(59.34%),electric bike accident(17.35%),bike accident(9.76%),motorcycle accident(4.56%),walking accident and the others.3.The origin of the patient,the severity of the injury:The origins of the 62 patients were not recorded in the database.The remaining 1148 cases were from the six downtown districts,438 cases were from the four districts of the around this city,361 cases were from the suburbs and 359 cases were from other provinces.According to the GCS division of the severity of the injury,the ratio of the injured severity of mild : moderate: severe was 9.78: 1: 1.56 in the patients from the six downtown districts,6.23: 1: 1.45 in the ones from the districts around and the suburb of the city and 7.17 : 1: 4.21 in the ones from other province.The difference was significantly different(P = 0.001).When compared the ratio of the severly injured patients from the downtown,around city and suburb,the ratio of the severe TBI patients in the ones from other provinces was biggest(P = 0.001).4.Diagnosis and treatment:The 1576 cases were first diagnosed and treated in our hospital,the mean time gap from the injury to the CT scanning was 7.53 hours.There was only 71 patients receiving neurosurgical diagnosis and treatment in1 hour after injury.The diagnosis of skull fracture was seen in 783 cases,the one of intracerebral hematoma was seen in 718 cases,86 patients lost their CT data.783 cases received surgical treatment,among them 457 cases received the installation of the intracranial pressure monitors.The most common surgical method was craniotomy to evacuate the cerebral hematoma,which was performed in 693 with or without decompressive craniectomy(DC).1585 patients improved by conservative treatment.The total rate of discharge was 84.00% and the mortality rate was 7.18%.Conclusion: The most often cause of TBI in the central city of China is the traffic accident.The proportion of women in TBI increases along with the increasing of their ages.Most patients are from the downtown of the central city,but the ones from the neighboring provinces and the districts around the city and the suburbs are also admitted to the central hospital.The time gap of injury to the diagnosis and treatment is still not ideal.It indicates that all the measurments such as improving the traffic facilities,strengthing the management of the drivers of the traffic vehicles such as electric vehicle,enhancing the traffic safety education to the aged female and pedestrians who prone to be victims in traffic accident and modifying the transport and the diagnosis and treatment process for the injured patients,may reduce TBI incidence and improve the therapeutic effectiveness. |
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