Clinical characteristics and prognosis of traumatic head injury following road traffic accidents admitted in ICU “analysis of 694 cases”

OBJECTIVETraumatic brain injury due to road traffic accidents occurs mainly in the younger age group in which injury-related disability leads to long-term impact on employment and economic and social consequences across the lifespan. This study was designed to assign a monetary cost (in Malaysian ringgits [RM]) to the treatment of patients with surgically treated isolated traumatic head injury as determined up to 1 year after injury.METHODSRelevant resource items used were identified and valued using the direct measurement of costs method, cost accounting methods, standard unit costs method, fees, charges and/or market prices method. These values were then tabulated to generate the total costs for each patient, via a combination of macro-costing and micro-costing methods. Malaysian currency values were converted to US dollars according to the average conversion rate for the period from January to May 2016: RM1 = US$0.2452.RESULTSThis costing study analyzed data from 49 patients. The estimated cost for the 1st year of care for all patients was RM1,471,919.80 (US$360,914.735), with a mean (± SD) cost per case of RM30,039.18 ± 22,986.25 or $7365.61 ± $5636.23. The mean cost of care per case was RM11,041.35 ± 10,936.88 or $2707.34 ± $2681.72 for mild head injury, RM32,550.00 ± 20,998.76 or $7981.26 ± $5148.90 for moderate head injury, and RM36,917.86 ± 23,697.34 or $9052.26 ± $5810.59 for severe head injury. Severe head injury (p = 0.001), sustaining 2 or more intracranial pathologies (p = 0.01), having a poor Glasgow Outcome Scale (GOS) score (GOS score 1–3) (p = 0.02), requiring a tracheostomy (p < 0.001), and contracting pneumonia (p < 0.001) were significantly associated with higher cost. Logistic regression analysis revealed that cost of care increased by RM591.60 or $145.06 per year increment of age (β = RM591.60, p = 0.05).CONCLUSIONSThe mean cost of treatment for traumatic head injury is high compared to the per capita income of RM37,900 in 2016. The cost values generated in this study provide baseline cost estimates that the authors hope will be used as a guide to determine where adequate funding should be allocated to provide timely and appropriate delivery of care.

Download Full-text

Investigating the Association between Orthopedic Fractures and Head Injury due to Road Traffic Accidents

Applied Bionics and Biomechanics ◽

10.1155/2021/2430090 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Mubarak Ali Algahtany

Keyword(s):

Head Injury ◽

Hospital Stay ◽

Traffic Accidents ◽

Road Traffic ◽

Road Traffic Accidents ◽

Traumatic Head Injury ◽

Chi Square ◽

Duration Of Hospital Stay ◽

Orthopedic Injury ◽

Tertiary Center

Background. Traumatic head injury (THI) due to road traffic accidents (RTAs) is a global health problem. Studies exploring the association between RTA-related THI and concurrent orthopedic fractures are lacking. We aim to provide a detailed analysis of this association and its impact on inhospital outcomes. Methods. Retrospective analysis of RTA-related THI associated with orthopedic fractures admitted to a large tertiary center, Southwest, Saudi Arabia, over ten years. Descriptive statistics for participant demographics and clinical outcomes were represented by percentages. The associations between head injury diagnosis or orthopedic fractures region and patient demographics are analyzed using the Chi-square test. Post hoc analysis for the significant Chi-square values was carried out by calculating the significant adjusted residuals. Adjust p value was obtained by using the Benjamini-Hochberg procedure to control for multiplicity testing. A p value less than 0.05 was considered statistically significant. Results. Concurrent orthopedic fractures are present in one-tenth of RTA-related THI. The cohort was dominated by young males, with 46.5% of the population between 18 and 29 years old. There was a significant association between the head injury diagnosis and the region of orthopedic fracture ( p = 0.028 ). The type of head injury had significant associations with mortality and duration of hospital stay ( p = 0.039 and p = 0.037 , respectively). The region of orthopedic fracture significantly ( p = 0.018 ) affected the duration of hospital stay, with fractures in the clavicle/shoulder region significantly ( p = 0.035 ) having a short course of hospital admission. Conclusion. Orthopedic fractures concomitant with RTA-related THI are common. The associations between the two injuries tend to happen in specific patterns. The inhospital stay duration and mortality significantly correlated with the site of the head or orthopedic injury. Knowledge of these patterns improves the care of THI victims, triaging, and resource allocations.

Download Full-text

Outcome of cerebral contusion in mild traumatic head injury patients

International Surgery Journal ◽

10.18203/2349-2902.isj20195118 ◽

2019 ◽

Vol 6 (11) ◽

pp. 4032

Author(s):

Jagadish B. Hedawoo ◽

Maheshkumar S. Soni

Keyword(s):

Head Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Traumatic Head Injury ◽

Cerebral Contusion ◽

Mild Tbi ◽

Tertiary Centre ◽

Traumatic Head ◽

Ct Brain ◽

Gcs Score

Background: Mild traumatic head injury is classified as one with Glasgow coma scale (GCS) score between 13 and 15. The aim of the study was to find underlying cause of deterioration of mild traumatic brain injury (TBI) and its association with other factors like bony injury.Methods: A prospective observational study at a tertiary centre with patients admitted for mild TBI with GCS 13-15 were followed up in ward and reviewed after every 6 hours interval, those who deteriorated repeat computed tomography (CT) scan was done for further diagnosis and intervention.Results: Determining the level of deterioration after 24 hours observation following mild TBI, 268 (63.4%) of the admitted patients were discharged home after 24 hours of observation, 89 (20.7%) needed more observation while 63 (14.8%) deteriorated and 3 (0.7%) died. As the GCS on admission was decreasing; deterioration increased i.e., 12.7%, 16.7% and 33.3% for GCS of 15, 14 and 13 respectively. Likewise, as the GCS increased, recovery improved. Subdural haematoma (39.7%) was the leading cause of deterioration while (13.8%) despite their deterioration, CT brain did not reveal any abnormality.Conclusions: Patients presenting with mild TBI (i.e., GCS- 13-15) secondary to high velocity/energy trauma i.e., road traffic accidents have to be carefully observed for at least 24-48 hours post-trauma as the chances for neurological deterioration are significant especially in polytrauma patients. The most cause for deterioration is subdural haemorrhage among others, has to be investigated so appropriate management for the same can be instituted as soon as possible.

Download Full-text

Secular Trend, Seasonal Variation, Epidemiological Pattern, and Outcome of Traumatic Head Injuries Due to Road Traffic Accidents in Aseer, Saudi Arabia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126623 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6623

Author(s):

Mubarak Ali Algahtany

Keyword(s):

Saudi Arabia ◽

Seasonal Variation ◽

Head Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Skull Fracture ◽

Road Traffic Accidents ◽

Female Ratio ◽

Common Diagnosis ◽

Traumatic Head

Road traffic accidents (RTAs) are a leading cause of traumatic head injury (THI) and are regarded as a public health problem in Saudi Arabia. This hospital-based retrospective study aims to provide data on the frequency, type, and distribution of RTA-related THIs over the past decade; demonstrate their time trend and seasonality; and decipher age and sex differences in RTA-related THIs and their outcome. The results showed a decline in the number of RTA-related THIs between 2010 and 2019. The patients had a mean age of 26.16 ± 16.27 years, and the male-to-female ratio was 10.8:1. Head injury with multiple lesions was the most common diagnosis, followed by cerebral contusion and skull fracture (32.1%, 12.9%, and 11.2%, respectively). Subdural hematoma (SDH) and skull fracture were significantly more common in patients aged ≥60 years (standard residual > 1.96), and significantly less common in those aged ≤17 years (standard residual < 1.96), compared to other age groups. Males experienced significantly more SDHs than females (standard residual = −2.8, p = 0.029). The length of hospital stay was positively correlated with age (Spearman’s rho = 0.057, p = 0.046). No seasonal variation was found.

Download Full-text

Etiological Factors of Extradural Haematoma: Experience of 80 Cases in Bangladesh

Journal of Science Foundation ◽

10.3329/jsf.v14i2.33444 ◽

2017 ◽

Vol 14 (2) ◽

pp. 44-48

Author(s):

Md. Abdus Salam ◽

Md. Shafiul Alam ◽

Kalim Uddin ◽

Md. Ashraful Haque ◽

Md. Mahfuzur Rahman ◽

...

Keyword(s):

Head Injury ◽

Road Traffic ◽

Cross Sectional Study ◽

Extradural Haematoma ◽

Age Group ◽

Traumatic Head Injury ◽

College Hospital ◽

Cross Sectional ◽

Etiological Factors ◽

Traumatic Head

Background: Extradural haematoma is due to different etiologies.Objectives: The purpose of the present study was to see the etiological factors of extradural haematoma.Methodology: This cross sectional study was conducted in the Department of Neurosurgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2010 to June 2011 for a period of one year and half months. All patients who underwent surgery with traumatic head injury having extradural haematoma were included in the study. At admission, a detailed history of the illness was taken from the patients/patients attendants by face-to-face interview with the help of a preformed questionnaire. Questionnaire was prepared with key variables like age, sex and mode of injury.Result: Eighty (80) patients of traumatic head injury within and after 24 hours of head injury were enrolled in this study. 20(25.1%) patients were present in age group of 11 to 20 years. 19(23.8%) patients were in age group of 21-30 years. 20(25.1%) patients were present in age group of 31 to 40 years. Male was predominant than female which was 60(75.0%) cases and 20(25.0%) cases respectively. The most common mode of injury was road traffic accident which was 51(63.7%) cases followed by fall from height and assault which were 16(20.0%) cases and 13(16.3%) cases respectively.Conclusion: In conclusion RTA is the most common cause of extradural haematoma.Journal of Science Foundation, July 2016;14(2):44-48

Download Full-text

DEMOGRAPHIC STUDY OF DEATHS DUE TO ROAD TRAFFIC ACCIDENTS, EXAMINED IN DR. S.N. MEDICAL COLLEGE, JODHPUR (RAJ.)

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i8.1364 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Kana Ram Patel ◽

Jagdish Jugtawat ◽

Shalender Kumar ◽

P.C. Vyas

Keyword(s):

Head Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Head Injuries ◽

Subdural Hemorrhage ◽

Age Group ◽

Road Traffic Accidents ◽

Female Ratio ◽

Medical College ◽

Male To Female

Accidents are not due to external factors all the time but often they occur due to failure of control of self-conscience and free thoughts. Road Traffic Accidents is still the major cause of death worldwide including India. A retrospective study has been conducted in Dr. S.N. Medical College, Jodhpur (Raj.), in the year 2019 to study the pattern and distribution of Head Injuries of fatal road traffic accidents and to prepare the demographic profile of it. Out of total 901 cases, male to female ratio was 9:1, and commonest age group affected was 21-30 years (39.8%). Among total victims, Hindus were 748 (83%) and rests were Muslims 103 (11.4%) and other religions. Head injury was the most common injury, present alone in 509 cases (56.4%) and in 392 (43.6) cases along with other injuries. Skull fractures were found in 451 (50.5), in which linear/fissure fracture (32.9%) was most common. Most common bone fractured was temporal bone. The commonest variety of intracranial hemorrhage was subdural hemorrhage and craniotomy was done in 29 (3.2%) cases. Keywords: Accidents, Road traffic, Head injury, Fractures.

Download Full-text