The Changing Trend of Head Injury at Tertiary Referral Hospitals

Khadka NK*, Shrestha R**, Bhandari R***, Bista P****, Jha R*****

Abstract


Introduction: Bir Hospital and National Trauma Centre receive many trauma patients including head injuries. Over the time, care and facilities for the management of head injury patients have improved. It is a reasonable practice to evaluate the trend of head injury and their outcomes in recent times.

Method: This was a retrospective study to find the frequency and aetiology of head injury and their outcomes at two tertiary level referral hospitals. Data of all patients with head injury attending Emergency Departments of these two hospitals were collected retrospectively for two and a half years. The conscious level was assessed in terms of the Glasgow Coma Scale (GCS) and outcomes were measured in the Glasgow Outcome Score (GOS).

Result: A total of 1070 head injury patients were admitted for neurosurgical intervention out of 8526 trauma patients who attended the Emergency Departments of Bir Hospital and National Trauma Center. Rest of the patients were discharged or had mild head injuries associated with major injuries of extremity fractures, maxilla-facial, abdomen, and chest injury. Those patients were admitted by respective departments. The male and female ratio was 2.6:1. Among total admitted head injury patients, most of them (55%) had road traffic accident (RTA), followed by fall from height (36%), physical assault (6%) and other causes of head injury (3%) respectively. Surgeries including the evacuation of intracranial haematomas were required in 325 cases (30%).
The majority (91%) of the patients had a favourable outcome at discharge. The number of patients who died during hospital admission was 45; the head injury mortality was 4.2%.

Conclusion: The mortality of head injury at Bir Hospital and National Trauma Centre is low in this study and seems to be on a decreasing trend in recent years.

Keywords: Glasgow Coma Scale, Glasgow Outcome Scale, Head Injury, Intracranial Hematoma, Trauma.

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