Pattern of head injuries in patients admitted in tertiary trauma Centre.

Abstract

Objectives: The aim of study to know the pattern of injury in terms of severity & outcome in patients with head injuries admitted in trauma unit of a tertiary care Centre. Study Design: Descriptive Study. Setting: Trauma Centre, Peoples medical university hospital Nawabshah. Period: From June, 2018 to May, 2019. Material & Methods: This included 385 patients admitted in trauma unit of Neurosurgery Department of Peoples medical university hospital Nawabshah, through emergency Department with head injury sustained due to road traffic accident, fall, sports related injuries or Assault etc as evident on CT scan brain (plain) with bone window. Patients with poly trauma, bleeding disorders, previously operated and those who failed to turn up in OPD for follow up were excluded.  Glasgow Coma Scale (GCS) was used for categorizing the subjects with head injury into mild (GCS 14-15), moderate (GCS 9-13) and severe injury (GCS 3-8). CT scan brain with bone window was done in all patients. These were then managed accordingly according to the severity of the injuries. Follow up Glasgow Coma Outcome scale was used to assess the outcome in these patients. Results: Regarding nature of traumatic injuries in these patients commonest were contusion (21.8%), extradural hematoma (27.5%), subdural hematoma (22.3%), diffuse axonal injury (13.2%), and subarachnoid hemorrhage (4.2%). This was followed by skull fracture (7.3%) and intracerebral hemorrhage (3.6%). Majority of the patients were with severe head injury. Glasgow Outcome Scale of Patients at Follow- up reveled complete recovery in 106 (27.5 %), Mild disability in 81(21.0%), Moderate Disability in 64 (16.6%), Severe Disability in 72 (18.7%), Persistent Vegetative state in 36 (9.4%), and death in 26 (6.8 %). Conclusion: Good outcome is observed in patients who are properly treated by continuous monitoring & timely surgical intervention in a tertiary care hospital.