DOI: http://dx.doi.org/10.18203/2349-2902.isj20204672

The audit of traumatic head injuries in a tertiary care hospital in Mumbai: a retrospective study

Snehal Deotale, Vivek Mukhamale, Bhushankumar A. Thakur, Rajas Mudgerikar

Abstract


Background: Trauma and trauma related deaths are a major health concerns in any country of which half of the deaths are due to head injuries. Yet reliable statistics are difficult to discover from routinely collected data. This study helps to analyse the epidemiology, mortality and morbidity of traumatic head injury patients in a tertiary care hospital in Mumbai.

Methods: Retrospective data of one year (1st January 2019 to 31st December 2019) was collected from Medical records department. Demographic data, mode of injury, severity of injury, interventions done, duration of hospital stay, mortality and morbidity were recorded.

Results: Of the total 944 cases recorded, 785 (83%) were males. More than half of the patients were below 40 years of age. The leading cause of trauma was RTA (79%) followed by accidental fall (18%). Of all the trauma patients 110 (11%) were found to be under influence of alcohol. 77 patients (8%) on admission had poor GCS (0-3), while 766 (81%) on admission had good GCS (8 and above). 153 patients (16%) underwent neurosurgical intervention. Average length of hospital stay of most patients (545) was 4 to 7 days. Total mortality was 111 (12%). Mortality was high in patients with poor GCS on admission.

Conclusions: The above study gives statistics regarding the epidemiology, morbidity and mortality of patients of traumatic head injuries in a tertiary care hospital which can be used for future references in designing management policies to prevent traumatic head injuries.


Keywords


Audit, Head injury, Trauma

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References


Peden M, McGee K, Sharma G. The injury chart book: a graphical overview of the global burden of injuries. Geneva, World Health Organization; 2002: 6-9.

Jennett B. Epidemiology of head injury. J Neurol Neurosurg Psychiatr. 1996;60(4):362-9.

Shravat BP, Huseyin TS, Hynes KA. NICE guideline for the management of head injury: An audit demonstrating its impact on a district general hospital, with a cost analysis for England and Wales. Emerg Med J. 2006;23:109-13.

West JG, Cales RH, Gazzaniga AB. Impact of regionalization: the orange county experience. Arch Surg.1983;118:740-4.

Joshipura MK, Shah HS, Patel PR, Divatia PA, Desai PM. Trauma care systems in India. Injury. 2003;34:686-92.

Mock CN, Jurkovich GJ, Arreola-Risa C, Maier RV. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development including commentary by Jacobs LM Jr., McSwain NE Jr., and Leppaniemi AK. J Trauma Acute Care Surg. 1998;44(5):804-14.

Fitzgerald M, Dewan Y, O’Reilly G, Mathew J, McKenna C. India and the management of road crashes: Towards a national trauma system. Indian J Surg. 2006;68:226-32.

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. Chinese Med J. 2008;128:1080-4.

Karasu A, Civelek E, Aras Y, Sabanci PA, Cansever T, Yanar H, et al. Analyses of clinical prognostic factors in operated traumatic acute subdural hematomas. Ulusal Travma ve Acil Cerrahi Dergisi. 2010;16:233-6.

Agrawal 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. Indian J Neurotrauma. 2012;9:87-92.

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

Sharma BR, Gupta M, Bangar S, Singh VP. Forensic considerations of missed diagnoses in trauma deaths. J Forens Legal Med. 2007;14:195-202.

Sidhu DS, Sodi GS, Banerjee AK. Mortality profile in trauma victims. J Indian Med Assoc. 1993;91(1):16-8.

Jha N, Srinivasa DK, Roy G, Jagdish S. Injury pattern among road traffic accident cases: a study from South India. Indian J Community Med. 2003;2:85-90.

O’Toole O, Mahon C, Lynch K, Brett FM. Is the contribution of alcohol to fatal traumatic brain injuries being underestimated in the acute hospital setting? Irish Med J. 2009;102:223-4.

Galbraith S, Murray WR, Patel AR, Knill-Jones R. The relationship between alcohol and head injury and its effect on conscious level. Br J Surg. 1976;63:138-40.

Jennett B, Teasdale G, Braakman R, Minderhoud J, Heiden J, Kurze T. Prognosis of patients with severe head injury. Neurosurgery. 1979;4(4):283-9.

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

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.

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. 1990;73:688-98.

Kortbeek JB, al Turki SA, Ali J, Antoine JA, Bouillon B, Brasel K, et al. Advanced trauma life support, 8th edition, the evidence for change. Journal of Trauma Injury Infect Crit Care. 2008;64(6):1638-50.