DOI QR코드

DOI QR Code

Survival-related Factors in Patients with Traumatic Acute Subdural Hematoma

외상성 급성 경막하 혈종 환자의 생존 관련 요인

  • Ha, Hey-Jin (Department of Nursing, Dongshin University) ;
  • Woo, Sang-Jun (Department of Nursing, Dongshin University) ;
  • Lee, Seung-Woo (Trauma intensive care unit, Chonnam university hospital)
  • 하혜진 (동신대학교 간호학과) ;
  • 우상준 (동신대학교 간호학과) ;
  • 이승우 (전남대학교병원 외상중환자실)
  • Received : 2021.01.27
  • Accepted : 2021.04.20
  • Published : 2021.04.28

Abstract

This study is a retrospective study attempted to determine the factors that influence the survival of patients with traumatic acute subdural hematoma. The study subjects were 207 patients with traumatic subdural hematoma who visited the emergency room from January 2017 to February 2019 at C University Hospital in G Metropolitan City. Data analysis was using the SPSS 23.0 program, and χ2-test, t-test, and logistic regression analysis. As a result of the study, the factors affecting the survival of the subjects were under disease, complications, and initial GCS. Therefore, it is necessary to establish a medical system to check the subject's history and to train medical staff to prevent complications. In addition, it is necessary to improve the transfer system so that the GCS of the subject can be measured from the stage before transfer to a medical institution and transferred to a hospital that can be treated quickly.

본 연구는 외상성 경막하 혈종 환자의 생존 여부에 영향을 미치는 요인을 규명하기 위해 시도된 후향적 조사연구이다. 연구대상자는 G광역시에 소재한 C대학교 병원에 2017년 1월부터 2019년 2월까지 응급실로 내원한 외상성 경막하 혈종 환자 207명이다. 자료분석은 SPSS 23.0 프로그램을 이용하였으며, χ2-test, t-test, 로지스틱 회귀분석을 시행하였다. 연구결과 대상자의 생존 여부에 영향을 미치는 요인은 기저질환, 입원 시 합병증, 내원 시 GCS로 나타났다. 따라서 대상자의 과거력을 확인할 수 있는 의료시스템 구축과 합병증 예방을 위한 의료진의 교육이 이루어져야 할 것이다. 이와 함께 의료기관 이송 전 단계부터 대상자의 GCS를 측정하여 신속히 치료 가능한 병원으로 이송될 수 있도록 이송체계의 개선이 필요하다.

Keywords

References

  1. A. A. Hyder, C. A. Wunderlich, P. Puvanachandra, G. Gururaj & O. C. Kobusingye, (2007). The Impact of Traumatic Brain Injuries: A Global Perspective. NeuroRehabilitation, 22(5), 341-353. https://doi.org/10.3233/nre-2007-22502
  2. V. G, Coronado, K. E. Thomas, R. W. Sattin & R. L. Johnson, (2005). The CDC Traumatic Brain Injury Surveillance System: Characteristics of Persons Aged 65 Years and Older Hospitalized with a TBI. The Journal of Head Trauma Rehabilitation, 20(3), 215-228. https://doi.org/10.1097/00001199-200505000-00005
  3. W. P. Hong. (2019). Effect of Prehospital Oxygen Administration on Hospital Outcomes after Severe Traumatic Brain Injury. Doctoral dissertation. SNU, Seoul.
  4. T. S. Im, et al. (2014). Comparative Study of Surgical Outcome and Prognosis on the Aged versus the Super-aged Patients with Acute Subdural Hematoma in Moderate Traumatic Brain Injury. Journal of Korean Society of Geriatric Neurosurgery, 10(2), 121-127.
  5. K. H. Kim. (2009). Predictors for Functional Recovery and Mortality of Surgically Treated Traumatic Acute Subdural Hematomas in 256 Patients. Journal of Korean Neurosurgery Society, 45(3), 143-150. DOI : https://doi.org/10.3340/jkns.2009.45.3.143
  6. J. T. Park & J. K. Yun. (2013). Case Report : The Use of Multiple Fenestrations of the Dura in Acute Traumatic Subdural Hematoma in Elderly. Journal of Trauma and Injury, 26(3), 226-228.
  7. S. S. Han, K. W. Jung, J. S. Kwon, J. Y. Kim, S. C. Choi & K. J. Lee. (2011). Problems with Transferring Major Trauma Patients to Emergency Medical Center of a University Hospital from another Medical Center. Journal of Korean Association of Traumatology, 24(2), 118-124.
  8. S. H. Choi, J. D. Moon, S. J. Kim, C. G. Moon, S. W. Lee & Y. S. Hong. (2001). Prognostic Factors in Head Trauma Patients. Journal of the Korean Society of Emergency medicine, 12(2), 105-118.
  9. H. W. Ryu. et al. (2020). Comparison of the New and Conventional Injury Severity Scoring Systems for Predicting Mortality in Severe Geriatric Trauma. Journal of the Korean Society of Emergency Medicine, 31(6), 543-552.
  10. M. H. Ji & H. R. Choi. (2020). Risk Factors of Intracranial Hemorrhage in Skull Fracture after Pediatric Head Trauma. Journal of Korean Biological Nursing Science, 22(1), 45-52. DOI: 10.7586/jkbns.2020.22.1.45
  11. H. M. Kim & D. H. Kim. (2019). Neuro-ophthalmic Analyses of Head Trauma Patients. Journal of the Korean Ophthalmological Society, 60(11), 1105-1111. DOI: 10.3341/jkos.2019.60.11.1105
  12. D. J. Levinson, C. N. Darrow, E. B. Klein, M. H Levinson & B. Mckee. (1978). The Seasonsofaman's lve. New York, NY: Ballantine.
  13. Tugay Atalay, H. A., Gulsen, I., & Karacabey, S. (2019). Risk Factors associated with Mortality and Survival of Acute Subdural Hematoma: A Retrospective Study. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 24. 14-16. DOI: 10.4103/jrms.JRMS_14_16
  14. M. R. Bullock. et al. (2006). Surgical management of acute subdural hematomas. Neurosurgery, 58(suppl_3), S2-16.
  15. J. M. Pang, I. Ng. A. Civil, D. Adams, & T. Koelmeyer. (2008). Is the Trimodal Pattern of Death after Trauma a Dated Concept in the 21st century? Trauma Deaths in Auckland 2004. Injury, 39(1), 102-106. https://doi.org/10.1016/j.injury.2007.05.022
  16. I. Yilmaz et al. (2019). Factors associated with Mortality in Acute Subdural Hematoma: Is Decompressive Craniectomy Effective?. Turkish Journal of Trauma & Emergency Surgery, 25(2), 147-153. DOI : 10.5505/tjtes.2018.48079
  17. B. O. N. D. Jennett, G. Teasdale, R. Braakman, J. Minderhoud, & R. Knill-Jones. (1976). Predicting Outcome in Individual Patients after Severe Head Injury. The Lancet, 307(7968), 1031-1034. https://doi.org/10.1016/S0140-6736(76)92215-7
  18. S. J. Kim. (2019). Application of Trauma Severity Indices at Pre-Hospital Stage for Evaluation of Early Prognosis in Trauma Patients. Journal of the Korean society for Wellness. 14(2), 419-429. DOI :10.21097/ksw.2019.05.14.2.419
  19. K. W. Jung et al. (2011). Delayed Transfer of Major Trauma Patients Under the Current Emergency Medical System in Korea. Journal of Trauma and Injury, 24(1), 25-30.