Purpose

This study was primarily aimed at establishing the incidence and impact of hypotension in patients with blunt traumatic brain injury based on National Trauma Registry Database.

Methods

A retrospective cohort study using the National Trauma Registry was conducted. Patients with TBI following blunt mechanisms of injury were examined, comparing those with and without hypotension (SBP < 90 mm Hg) on arrival.

Results

During the period from 1998 to 2017, the registry included 437.354 blunt trauma patients. Of them, 7818 patients were hemodynamically unstable (SBP < 90 mm Hg) on admission. 513 met the inclusion criteria. Significant percentages of patients with high grade injures (ISS≥16) and low admission’s GCS 3-12 (46% vs 16.4%), were found in the group of hypotensive TBI patients (p<0.0001). 323 (62.9%) patients had head AIS score 3-4 and only 190 (37.1%) patients AIS 5-6 (p<0.0001). Mortality in the hypotensive TBI group was 32.3%, whereas 6.1% patients died in the TBI hemodynamically stable group (p<0.0001)

Conclusion

TBI patients presenting with hypotension represent an appreciable portion blunt trauma patients. Prompt brain CT, expedient efforts at optimal resuscitation and possibly early inotropic and vasopressors agents use may have an impact on final outcome in these patients.

中文翻译：

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孤立性脑外伤患者入院时的低血压：使用国家注册簿对发病率和预后进行当代检查。

目的

这项研究的主要目的是根据国家创伤登记数据库，确定钝性颅脑外伤患者低血压的发生率和影响。

方法

使用国家创伤登记处进行了一项回顾性队列研究。对具有钝性损伤机制的TBI患者进行了检查，比较了有无低血压（SBP <90 mm Hg）的患者。

结果

在1998年至2017年期间，登记册包括437.354名钝性创伤患者。其中7818例患者入院时血流动力学不稳定（SBP <90 mm Hg）。513名符合纳入标准。在低血压TBI患者组中，有高比例损伤（ISS≥16）和低入院GCS 3-12的患者百分比显着（46％vs 16.4％）（p <0.0001）。323名（62.9％）的患者AIS评分为3-4，而只有190（37.1％）的AIS评分为5-6（p <0.0001）。低血压TBI组的死亡率为32.3％，而TBI血流动力学稳定组的患者死亡6.1％（p <0.0001）

结论

表现为低血压的TBI患者代表了一部分钝性创伤患者。迅速进行脑部CT检查，快速进行最佳复苏以及尽早使用正性肌力药和血管加压药可能会对这些患者的最终结局产生影响。