DOI: http://dx.doi.org/10.18203/2349-2902.isj20195386

Comparative study of pattern of head injury in a rural community hospital and a tertiary care hospital

Suhas Patil, Tanweerul Huda, Sheel C. Jain, Bharati Pandya, Ravinder Narang

Abstract


Background: The objective of the study was to compare clinical patterns of head injuries in reference to the Glasgow coma scale including neurological examination and also to determine morbidity and mortality in head injury patients admitted to a nodal tertiary care hospital and a rural community hospital.

Methods: This prospective study was done at the emergency department of Kasturba Hospital attached to Mahatma Gandhi Institute of Medical Sciences and Sushrut Hospital, Maharashtra on a total of 1000 cases during one-year study duration. The severity of the head injury was analysed using a Glasgow coma scale and outcome in terms of management and death was assessed.

Results: Out of 1000 cases with head injuries, 900 cases were admitted in tertiary care hospital and 100 cases in a rural hospital. A significant difference was observed in terms of age group (p=0.01), mode of trauma (p=0.04) and symptoms (p=0.03) among the patients admitted with head injuries in both hospitals. The mortality rate was 1% and 3% in tertiary care and rural hospitals respectively.

Conclusions: Head injuries are predominantly affecting the male population and most of them are due to road traffic accidents. Early assistance of medical aid and emergency room care results in good outcomes with minimal deaths. 


Keywords


Head injury, Tertiary care hospital, Rural community hospital, Glasgow coma scale, Outcome

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References


Gupta A, Gupta E. Challenges in organizing trauma care systems in India, Indian J Community Med. 2009;34:75-6.

Geneva: World Health Organization. (2002) Projections of Mortality and Burden of Disease to 2030: Death by Income group; 2002.

Gururaj G. Epidemiology of traumatic brain injuries: Indian scenario. Neurol Res. 2002;24:24-8.

Yattoo G, Tabish A. The profile of head injuries and traumatic brain injury deaths in Kashmir. J Trauma Manag. Outcomes. 2008;2:5.

Hahn YS, Chyung C, Barthel MJ, Bailes J, Flannery AM, McLone DG. Head injuries in children under 36 months of age. Demography and Outcome. Childs Nerv Syst. 1988;34:34-40.

Colohan AR, Alves WM, Gross CR, Torner JC, Mehta VS, Tandon PN, et al, Head injury mortality in two centers with different emergency medical services and intensive care. J Neurosurg. 1989;71202-207.

Waxman K, Sundine MJ, Young RF. Is early prediction of outcome in severe head injury possible?. Arch Surg. 1991;126:1237-42.

Graham DI, SaatmanN KE, Marklund N. The neuropathology of trauma. In: Evans RW, ed. Neurology and Trauma. 2nd ed. Oxford: New York; 2006: 45-94.

Teasdale G, Jennett B. Assessment of coma and impaired consciousness. Lancet. 1974;1:81-3.

Shekhar C, Gupta LN, Premsagar IC, Sinha M, Kishore J. An epidemiological study of traumatic brain injury cases in a trauma centre of New Delhi (India). J Emerg Trauma Shock. 2015;8(3):131-9.

Mushkudiani NA, Engel DC, Sterberg EW, Butcher I, Juan LU, Marmarou A, et al. Prognostic values of demographic characteristics in traumatic brain injury: results from the IMPACT study. J Neurotrauma. 2007;24:259-69.

Rao BH, Satyavaraprasad K, Rajiv PK, Kumar PV, Phaneeswar T. Epidemiological Study of Head Injuries in Andhra Medical College, King George Hospital, Visakhapatnam. Int J Sci Study. 2015;3(9):90-5.

Adeleye AO, Ogun MI. Clinical epidemiology of head injury from road-traffic trauma in a developing country in the current era. Front Neurol. 2017;15(8):695.

Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997;349:1498-504.

Bhole AM, Potode R, Agarwal A, Joharapurkar SR. Demographic profile, clinical presentation, management options in cranio-cerebral trauma: An experience of a rural hospital in central India. Pak J Med Sci. 2007;23:724-7.

Bernat JL, Schwartz GR. Brain death and organ retrieval, Resuscitation Part-I; 1998: 88-89.

Mamelak AN, Pitts LH, Damron S. Predicting survival from head trauma 24 hours after injury: A practical method with therapeutic implications. J Trauma. 1996;41:91-9.

Rajendra PB, Mathew TP, Agrawal A, Sabharawal G. Characteristics of associated craniofacial trauma in patients with head injuries: an experience with 100 cases. J Emerg Trauma Shock. 2009;2(2):89-94.

Roka YB, Kumar P. Role of repeat CT scan head in initially inoperable cases of traumatic head injury, Nepal Med Coll J. 2008;10(4):225-9.

Mock C. Improving pre-hospital trauma care in rural areas of low-income countries. J Trauma. 2003;541197-8.

Bahloul M, Chilly H. Traumatic head injury in children in south T Unisia epidemiology, clinical manifestation and evaluation (A propos 454 cases). Tunis Med. 2009;87(1):28-37.