Analysis Of The Current Situation And Related Factors Of Severe Traumatic Brain Injury Caused By Traffic Accidents

Objective: Severe traumatic brain injury(s TBI)has a high incidence in traffic accidents and is difficult to treat before hospitalization.This study aims to identify the high-risk population for s TBI in traffic accidents by analyzing the current situation of patients with severe traumatic brain injury caused by traffic accidents,in order to provide early safety education and prevention.Due to the high disability and mortality rates of s TBI,it is necessary to explore the risk factors affecting the prognosis of patients with traffic accident induced s TBI,which can provide reference for early Prehospital Emergency Care of s TBI patients.Methods: Retrospective collection of clinical data on patients with severe traumatic brain injury caused by traffic accidents at Zhangjiagang NO.1 People’s Hospital from Jan.1st,2017 to Dec.1st,2020.According to the prognosis of s TBI patients three months after discharge,the study subjects were divided into a good prognosis group and a poor prognosis group based on the Glasgow prognosis score.Statistical methods such as independent sample T-test,chi square test,and Mann Whitney U-test were used to analyze the epidemiological situation of severe traumatic brain injury caused by traffic accidents;Analyze the distribution of brain injury types in patients through imaging examinations;Compare the prognosis of severe traumatic brain injury caused by different means of transportation(trucks,buses,cars,electric vehicles,bicycles);The impact of whether electric bike riders wear helmets on the prognosis of craniocerebral injury and related clinical data;In addition,by comparing the prognosis analysis of different emergency measures,simple and effective emergency measures can be identified to implement targeted and effective emergency measures in clinical rescue,thereby improving the success rate of treatment for severe Craniocerebral Injury by Traffic AccidentsResults:1.This study collected the complete case information of 1238 patients with severe brain injury caused by traffic accidents.The proportion of male and female patients was 3.06:1,and the proportion of male patients was significantly higher than that of female patients.Among them,the highest incidence rate was found in the population aged 31-45(413 cases,33.34%),followed by the population aged 16-30(353 cases,28.54%).The injured models were mainly electric vehicles(580 cases,46.89%).Traffic accidents occurred on second-class highway(468 cases,37.77%)and sunny days(561 cases,45.24%)with the highest probability.The injury type was mainly impact injury(853 cases,68.92%).2.Describe the type of brain injury based on anatomical classification.Among 1238 patients with severe head injury,the common types include brain contusion and laceration(93%),skull fracture(70%),subdural hematoma(59%),subarachnoid hemorrhage(55%),brainstem injury(30%),epidural hematoma(28%),and diffuse axonal injury(23%).The proportion of brain contusion and laceration was the highest in both groups of patients,with 51% and 42%,respectively.Compared with the group with good prognosis,the proportion of brainstem injury and diffuse axonal injury in the group with poor prognosis is significantly higher.Among traffic accidents,electric vehicles were the most common(580 cases,46.89%),followed by automobiles(342 cases,27.64%).There are 88 cases of electric vehicles in the group with good prognosis,accounting for 18.97%.In the group with poor prognosis,there were 492 cases,3.The proportion is as high as 63.56%.The main comorbidities of patients with craniocerebral injury include limb fractures(20%),clavicle and rib fractures(17%),and shock(26%).The shock rate in the poor prognosis group is much higher than that in the good prognosis group.4.Among the 580 electric bike riders in this study,there were as many as 397(68.41%)without helmets,of which 387(97.48%)had poor prognosis;There were 183 cases(31.59%)wearing helmets,of which 105 cases(56.15%)had poor prognosis.The comparison between the two groups(P<0.001)showed statistical significance.Meanwhile,compared to wearing a helmet,electric bike riders who did not wear a helmet had a lower initial GCS score(6.5 ± 1.5 vs 4.3 ± 1.4,P<0.001),were more likely to require neurosurgical intervention(12.52% vs 38.56%,P<0.001),and had a higher proportion of deaths(7.89% vs 40.8%,P<0.001),while the length of stay in the ICU was not statistically significant(14 [7,21] vs 14 [4.5,22],P=0.625).5.The proportion of patients in the group with good prognosis receiving prehospital emergency measures is significantly higher than that in the group with poor prognosis.The univariate analysis of emergency measures for traffic accident induced brain injury shows that measures such as maintaining respiratory patency and temperature control can effectively improve prognosis.Conclusion:1.From the analysis of epidemiology and population distribution,it can be concluded that the proportion of men is significantly higher than that of women,and the highest incidence rate is among the population aged 31-45.Attention should be paid to strengthening road traffic safety education for this population.2.Brain contusion,laceration,and skull fracture are the most common imaging manifestations in patients,while brainstem injury and diffuse axonal injury often indicate poor prognosis.3.Electric bike riders have the highest proportion of traffic accidents.Electric bike riders without helmets have the highest risk of brain injury among all categories.Helmets,as the main protective device for electric bike riders,play a crucial role in personnel safety.4.Correct and effective prehospital emergency treatment can improve patient survival rate and prognosis,but it is still necessary to increase the proportion of prehospital emergency measures.