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。

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.

表目錄i
圖目錄iii
第一章 緒論p1
第一節、研究背景與動機p1
第二節、研究目的p13
第三節、名詞定義p14
第二章 文獻探討p18
第一節、老人外傷性腦受傷之發生情況p18
第二節、老人外傷性腦受傷之人口學特性p21
第三節、老人外傷性腦受傷之發生原因p23
第四節、老人外傷性腦受傷之嚴重度p26
第五節、老人外傷性腦受傷之預後結果p29
第六節、老人外傷性腦受傷之死亡情況p32
第七節、老人外傷性腦受傷之相關危險因子p34
第三章 研究方法與步驟p36
第一節、研究對象p36
第二節、研究地區與時間p39
第三節、研究架構p41
第四節、研究工具與資料分析p42
第四章 結果p43
第一節、基本人口學資料之分佈情形p43
第二節、相關類別變項之分佈情形p46
第三節、相關類別變項之交叉分析p56
第四節、相關類別變項之邏輯斯迴歸分析p71
第五章 討論p87
第六章 結論與建議p95
研究限制p101
參考文獻p102
附錄p112

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