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Abstract
Most studies of hospital deaths after head injury have been in patients transferred
to neurosurgical units (NSU), but over 90 per cent of hospitalized head-injured patients
are not transferred and some of these die. To assess the effectiveness of triage of
seriously head-injured patients in Glasgow, we studied 270 patients who died after
head injury in any of the six Glasgow general hospitals during 1979–1988 and who were
not transferred to the regional NSU. The proportion of fatal cases of head injury
who had not been to the NSU fell from 69 per cent in 1971–1975 to 45 percent in 1979–1988.
Most of the untransferred patients were elderly, and most died from irremediable injuries
or complications. Although 31 (11 per cent) had a significant intracranial haematoma,
only seven of these might have been salvaged by neurosurgical intervention. Seven
other patients died from potentially preventable extracranial injuries or complications.
These findings suggest that a relatively satisfactory level of triage of seriously
head-injured patients has been achieved, by promoting effective communication between
neurosurgeons and other specialists, and by a continuous programme of audit and education.
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References
- Guidelines for initial management after head injury in adults.Br. Med. J. 1984; 288: 983
- Retrospective study of 100 deaths from injury in England and Wales.Br. Med. J. 1988; 296: 1305
- The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care.J. Trauma. 1974; 14: 187
- Neurosurgical resources and transfer policies for head injuries.Br. Med. J. 1983; 286: 1791
- Audit of unconscious head injured patients transferred to a neurosurgical unit.Lancet. 1990; 1: 330
- Avoidable factors contributing to the death of head injury patients in general hospitals in Mersey Region.Lancet. 1981; 2: 459
- Preventable mortality and morbidity after head injury.Injury. 1978; 10: 31
- Head injury in three Scottish neurosurgical units.Br. Med. J. 1979; 2: 955
- Extradural haematoma effect of delayed treatment.Br. Med. J. 1979; : 1240
- Deaths following trauma: an audit of performance.Ann. R. Coll. Surg. Engl. 1991; 73: 53
- Patients with head injury who talk and die.Lancet. 1975; 2: 375
- Avoidable factors contributing to death after head injury.Br. Med. J. 1977; 2: 615
- Traumatic acute subdural haematoma; major mortality reduction in comatose patients treated within 4 hours.N. Engl. J. Med. 1981; 304: 1511
- Management of traumatic intracranial haematoma.Br. Med. J. 1982; 285: 1695
- Assessment of coma and impaired consciousness.Lancet. 1974; 2: 81
- Risks of acute traumatic intracranial haematoma in children and adults: implications for managing head injuries.Br. Med. J. 1990; 300: 363
- Age, severity and outcome of head injury.Acta Neurochir. Suppl. 1979; 28: 140
Article info
Publication history
Accepted:
February 24,
1992
Identification
Copyright
© 1992 Published by Elsevier Inc.
