台灣地區老人外傷性腦受傷之流行病學研究探討

Epidemiologic Study of Traumatic Brain Injury Among The Elderly in Taiwan

王薇琪(Wei-Chi Wang)

指導教授 ： 邱文達

臺北醫學大學/公共衛生暨營養學院/傷害防治學研究所/碩士(2007年)

https://doi.org/10.6831/TMU.2007.00044

摘要

在世界各國，外傷性腦受傷為重要的公共衛生議題，所造成的傷害更直接威脅生命，導致終生殘障、植物人等後遺症。本研究以台灣地區老年人外傷性腦受傷為議題，進行描述型流行病學的分析研究。本研究分析民國83年7月到民國95年6月於台灣地區55家公私立醫院65歲以上老年外傷性腦受傷病人資料，一共有18,788位老年人，平均年齡為75.12歲，男女比為1.72。結果顯示，老年人外傷性腦受傷的主因為跌落（佔48.57％）與車禍（佔43.93％），而大部分老年人外傷性腦受傷以輕度傷害（佔73.43％）居多，預後情況大多良好（佔66.72％）。男性受傷的嚴重度較女性來的嚴重，預後情況也較差。且隨著年齡的增加，受傷嚴重度較嚴重，預後情況也較差。受傷原因方面以車禍所造成的傷害最嚴重，預後情況最差，其次是跌落。若傷後出現神經障礙與顱內出血的病人，其死亡與變成植物人的危險性皆很高，危險對比值分別為16.46及14.42。而傷後出現神經障礙的病人其死亡的危險性為沒有出現的為15倍。由此可知，年齡、性別、受傷原因與相關臨床上症狀的出現都會對於老年外傷性腦受傷病人的受傷嚴重度、預後結果以及存活情況造成影響。

關鍵字

頭部外傷 ； 外傷性腦受傷 ； 老年人

並列摘要

Traumatic brain injury (TBI) is an important part in public health, because of death and permanent disabilities. This is an epidemiological study to investigate the TBI among the elderly in Taiwan. This study included patients from 55 medical facilities in Taiwan with age 65 years and older with history of TBI. During the period from 1994 to 2006, we included 18,788 patients in the study. The average age of the patients was 75.12 years old with the ratio of male to female 1.72. The results of this study showed that the TBI, major causes were falling accidents (48.57%) and traffic accidents (43.93%), and that most injuries were minor(73.43%) with good prognosis (66.72). But male patients were more often seriously injured than female patients with worse prognosis. With increasing age, the degree of injuries and prognosis become more severe. Traffic accidents inflicted the worst injuries and the worst prognosis followed by falling accidents. The possibility to become severe injury of TBI patients with neurological deficit and intracranial hemorrhage was high of death in TBI with the odds ratios are 16.46 and 14.42, respectively. The possibility of death in TBI patients with neurological deficit was 15 times higher than those without. Based on the study design, we suggest that patients’ age, gender, cause of injury and clinical symptoms can influence the severity, prognosis and survival of the elder TBI patients.

並列關鍵字

Head injury ； Traumatic brain injury ； Elderly

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