Evaluation of pattern and prognostic factors of head injury cases in a tertiary care centre

Authors

  • Ashish Anand Department of Surgery, PGIMS, Rohtak, Haryana, India
  • Surender Verma Department of Surgery, PGIMS, Rohtak, Haryana, India
  • Pradeep Garg Department of Surgery, PGIMS, Rohtak, Haryana, India
  • M. Taquedis Noori Department of Surgery, PGIMS, Rohtak, Haryana, India
  • Ankur Kajal Department of Surgery, PGIMS, Rohtak, Haryana, India
  • Anjali Verma Department of Pediatrics, PGIMS, Rohtak, Haryana, India

DOI:

https://doi.org/10.18203/2349-2902.isj20201865

Keywords:

Brain injury, Glasgow outcome scale, Multimodality approach

Abstract

Background: Head injury is a major public health problem worldwide and requires appropriate attention both regionally and globally. This study was done to find the patterns and to evaluate prognostic factors for final outcome of cranio-cerebral trauma.

Methods: A prospective study of 200 cases of head injury was conducted in a tertiary care hospital during one year duration. Apart from patient’s demographic profile detailed history and examination was recorded. Final outcome of all patients was noted at discharge and during follow up, various prognostic factors were studied by taking Glasgow outcome scale (GOS) at 3 months of head injury.

Results: This study included 156 (78%) males and 44 (22%) females with average age of 35.95 years. Assault followed by RTI was the main cause of TBI. The factors which correlated with poor prognosis are presence of increasing age, less GCS at admission, alcohol intoxication and multiple lesions on CT scan.

Conclusions: Prognostication of patients with head injury will help to provide timely multimodality approach which will ultimately help in improving outcome of these patients. 

References

Hunt RC, Krohmer JR. Advanced trauma life support, the evidence for change. J Trauma. 2008;64(6):1638-50.

Puvanachandra P, Hyder AA. The burden of traumatic brain injury in Asia: a call for research. Pak J Neurol Sci. 2009;4(1):27-32.

Jennett B, Bono M. Assessment of outcome after severe brain damage a practical scale. Lancet. 1975;1:480-4.

Tian HL, Chen SW, Xu T, Hu J, Rong BY, Wang G et al. Risk factors related to hospital mortality in patients with isolated traumatic acute subdural haematoma: analysis of 308 patients undergone surgery. Chin Med J. 2008;121:1080-4.

Karasu A, Civelek E, Aras Y, Sabanci PA, Cansever T, Yanar H, et al. Analysis of clinical prognostic factors in operated traumatic subdural haematomas. Ulus Trauma Acil Cerrahi Derg. 2010;16:233-6.

Agarwal A, Kakani A, Baisakhiya N, Galwankar S, Dwivedi S, Pal R. Developing traumatic brain injury data bank: prospective study to understand the pattern of documentation and presentation. Ind J Neurotrauma. 2012;9:87-92.

Hidayat SK. Acute head trauma CT scanning study. DMJ. 2007;1:69-89.

Mosenthal AC, Lavery RF, Addis M. Isolated traumatic brain injury: age is an independent predictor of mortality and early outcome. J Trauma. 2002;52:907-11.

Munro PT, Smith RD, Parke TR. Effect of patients’ age on management of acute intracranial haematoma: prospective national study. BMJ. 2002;325:1001.

Kotwica Z, Brzezinski J. Acute subdural haematoma in adults: an analysis of outcome in comatose patients. Acta Neurochir. 1993;121:95-9.

Marshall LF, Gautille T, Klauber MR. The outcome of severe closed head injury. J Neurosurg. 1991;75:528-36.

Phuenpathom N, Choomuang M, Ratanalert S. Outcome and outcome prediction in subdural Haematoma. Surg Neurol. 1993;40:22-5.

Cheung PS, Lam JM, Yeung JH, Graham CA, Rainer TH. Outcome of traumatic extradural haematoma in Hong Kong. Injury. 2007;38:76-80.

Rahman YS, Den A, Maull KI. Prospective study of validity of neurologic signs in predicting positive cranial computed tomography following minor head trauma. Prehosp Disaster Med. 2010;25:59-62.

Keatley E, Ashman T, Im B, Rasmussen A. Self reported head injury among refugee survivors of torture. J Head Trauma Rehabil. 2013;28(6):8-13.

Gupta PK, Krishna A, Dwivedi AN, Gupta K, Bala M, Garg G, et al. CT scan findings and outcome in head injury patients: a cross-sectional study. JPMS. 2011;1:78-82.

Seelig JM, Becker DP, Miller JD, Greenberg RP, Ward JD, Choi SC. Traumatic acute subdural hematoma: major mortality reduction in comatose patients treated within four hours. N Engl J Med. l98l;304:1511-8.

Haselsberger K, Pucher R, Auer LM. Prognosis after acute subdural or epidural hemorrhage. Acta Neurochir. l988;90:l l 1-6.

Howard MA, Gross AS, Dacey RG, Winn HR. Acute subdural hematomas: an age-dependent clinical entity. J Neurosurg. l989;71:858-63.

Bordignon KC, Arruda WO. CT scan findings in mild head trauma: a series of 200 patients. Arq Neuropsiquiatr. 2002;60:204-10.

Jennett B, Teasdale G, Braakman R, Minderhoud J, Heiden J, Kurze T. Prognosis of patient with severe head injury. Neurosurg. l979;4:283-9.

Eisenberg HM, Gary HE, Aldrich EF, Saydjari C, Turner B, Foulkes MA, et al. Initial CT findings in 753 patients with severe head injury a report from the NIH traumatic coma data bank. J Neurosurg. l990;73:688-98.

Fearnside MR, Cook RJ, Mcdougall P, McNeil RJ. The westmead head injury project outcome in severe head injury a comparative analysis of pre~hospital, clinical and CT variables. Br J Neurosurg. l993;7:267-79.

Selladurai BM, Jayakumar R, Tan YY, Low HC. Outcome prediction in early management of severe head injury: an experience in Malaysia. Br J Neurosurg. 1992;6:549-57.

Downloads

Published

2020-04-23

Issue

Section

Original Research Articles