| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Association of prehospital optimal blood pressure and peripheral oxygen saturation with hospital outcomes in sports-related and recreation-related traumatic brain injury (SRR-TBI) in Asia. |
| 掲載誌名 | 正式名：Emergency medicine journal : EMJ 略 称：Emerg Med J ISSNコード：14720213/14720205 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Jirayu Chantanakomes, Wasin Pansiritanachot, Sattha Riyapan, Sang Do Shin, Kyoung Jun Song, Wen-Chu Chiang, Sabariah Faizah Jamaluddin, Kentaro Kajino |
| 発行年月 | 2025/10 |
| 概要 | BACKGROUND:While Emergency Medical Services (EMS) guidelines improve outcomes in severe traumatic brain injury (TBI), the effect of optimal blood pressure and oxygenation on sports-related and recreation-related TBI (SRR-TBI) is unclear. This study assessed whether EMS management of systolic blood pressure (SBP) and oxygen saturation (SpO₂) influences outcomes in SRR-TBI.METHODS:This retrospective cohort study analysed data from patients diagnosed with TBI sustaining injuries during sports, education or leisure activities and were transported by EMS from 1 January 2016 to 31 December 2022, at Pan-Asian Trauma Outcomes Study facilities. Patients were classified as receiving optimal care (SBP>110 mm Hg and SpO₂>94%), intermediate care (either SBP<110 mm Hg or SpO₂<94%) or suboptimal care (both <thresholds). Outcomes were favourable neurological recovery (Modified Rankin Scale 0-3) and survival to discharge. Adjusted ORs with 95% CIs were calculated using multivariable logistic regression, adjusting for activity, age, sex, Charlson Comorbidity Index, mechanism and intent of injury, alcohol intake, time of injury and the Excess Mortality Ratio-adjusted Injury Severity Score.RESULTS:Among 4629 patients, 74% were male and 18.4% were <18 years old. Injuries occurred during education (3%), sports (14.5%) and leisure (82.5%). Care was optimal in 77.7%, intermediate in 19.6% and suboptimal in 2.7%. Favourable outcomes were 96.3%, 88.7% and 76%, with mortality of 0.9%, 4.7% and 8.8%, respectively (p<0.0001). Compared with suboptimal care, adjusted odds of favourable recovery and survival were 2.76 and 3.30 for optimal care, and 1.27 and 1.01 for intermediate care.CONCLUSION:Maintaining optimal SBP and SpO2 during EMS care is associated with better neurological outcomes and survival in patients with SRR-TBI. |
| DOI | 10.1136/emermed-2024-214031 |
| PMID | 41161702 |