[1]施申启　汪　玲　李承明　李　江　詹　砚　刘　帅　金　学　刘　丽.Helsinki CT评分系统对颅脑损伤远期预后的预测作用[J].中国临床神经外科杂志,2017,(12):824-827.[doi:10.13798/j.issn.1009-153X.2017.12.008]
　SHI Shen-qi,WANG Lin,LI Cheng-ming,et al.Prediction of long-term prognoses with Helsinki CT scoring system in patients with traumatic brain injury[J].,2017,(12):824-827.[doi:10.13798/j.issn.1009-153X.2017.12.008]
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Helsinki CT评分系统对颅脑损伤远期预后的预测作用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年12期
页码:
824-827
栏目:
论著
出版日期:
2017-12-25

文章信息/Info

Title:
Prediction of long-term prognoses with Helsinki CT scoring system in patients with traumatic brain injury
文章编号:
1009-153X（2017）12-0824-04
作者:
施申启　汪　玲　李承明　李　江　詹　砚　刘　帅　金　学　刘　丽
作者单位：430071 武汉，武汉大学基础医学院（施申启）；432800 湖北孝感，大悟县人民医院神经外科（施申启、李承明、李　江、詹　砚、刘帅、金学、刘　丽），消化内科（汪　玲）
Author(s):
SHI Shen-qi1; 2;  WANG Lin3;  LI Cheng-ming2;  LI Jiang2;  ZHAN Yan2;  LIU Shuai2;  JIN Xue2;  LIU Li2.
1. School of Basic Medical Science, Wuhan University, Wuhan 430071, China; 2. Department of Neurosurgery, Renmin Hospital of Dawu County, Xiaogan 432800, China; 3. Department of Gastroenterology, Renmin Hospital of Dawu County, Xiaogan 432800, China
关键词:
颅脑损伤; Helsinki CT评分; 远期预后; Logistic回归分析; 受试者工作特征曲线
Keywords:
Traumatic brain injury;  Helsinki CT scoring system;  Long-term outcome;  Multivariate logistic regression analysis
分类号:
R 651.1+5
DOI:
10.13798/j.issn.1009-153X.2017.12.008
文献标志码:
A
摘要:
目的 探讨Helsinki CT评分系统对颅脑损伤（TBI）远期预后的预测作用。方法 回顾性分析234例TBI的临床资料，包括Helsinki CT评分；伤后6个月采用GOS评分评估预后；采用多因素Logistic回归分析检验预后影响因素；采用受试者工作特征曲线评估Helsinki CT评分系统对TBI远期预后的效能。结果 234例中，死亡36例，植物生存28例，重残30例，中残73例，恢复良好67例。多因素Logistic回归分析结果显示，年龄、运动评分、瞳孔反射和Helsinki CT评分是TBI远期预后的独立影响因素。Helsinki CT评分对远期病死率和不良预后的预测能力较好[曲线下面积（AUC）死亡=0.82，AUC不良预后=0.77）；当Helsinki CT评分为4.5分时，预测病死率的特异性、敏感性和准确性分别为71.7%，80.5%和73.1%；当Helsinki CT评分为6.5分时，预测不良预后的特异性、敏感性和准确性分别为89.0%，53.9%和75.6%。结论 Helsinki CT评分是TBI远期预后的独立预测因子，当Helsinki CT评分为4.5分时，对远期死亡率的预测能力最强；当CT评分为6.5分时，对远期不良预后率的预测能力最强。
Abstract:
【Abstract】 Objective To explore the value of Helsinki CT scoring system to predicting long-term outcomes in the patients with traumatic brain injury (TBI). Methods The clinical data and Helsinki CT scores of 234 patients with TBI were analyzed retrospectively. The prognoses were assessed by GOS score 6 months after TBI in all the patients. The value, sensitivity and specificity of Helsinki CT scoring system in all the patients were investigated by multivariate Logistic regression analysis and area under the curve (AUC) analysis in all the patients. Results Multivariate Logistic regression analysis showed that the patient’s age, motor scores, pupil reflex and the Helsinki CT scores were independent predictors of long-term prognoses. In addition, the Helsinki CT scoring system better predicted the death rate and unfavorable outcomes (AUCdeath=0.82; AUCunfavorable=0.77) in all the patients with TBI. Its specificity and sensitivity to death were 71.7% and 80.5% respectively. Its specificity and sensitivity to unfavorable outcomes were 89.0% and 53.9% respectively. Conclusions It is suggested that Helsinki CT scoring system is an independent factor of predicting long-term outcomes, and it shows the most powerful discrimination for death prediction and unfavorable outcome prediction when its cut off value is 4.5 and 6.5 respectively in the patients with TBI.

参考文献/References:

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更新日期/Last Update: 2017-12-27