DISTRIBUTION AND CHARACTERISTICS OF HEAD INJURY AND REFERRAL NUMBER AT DR H. ANDI ABDURRAHMAN NOOR GENERAL HOSPITAL, TANAH BUMBU, SOUTH BORNEO, INDONESIA

2019 ◽  
Vol 1 (4) ◽  
Author(s):  
Komang Werdhi Sentosa ◽  
Ani Rahmawati ◽  
Daldy Arianda ◽  
Ardik Lahdimawan ◽  
Agus Suhendar

Background: Head injury (HI) has been one among leading causes of morbidity and mortality worldwide especially in the peripheries area. In South Borneo, 9.4% of trauma cases was a head injury. Especially, Tanah Bumbu Regency, one of peripheries area in South Borneo ranks third for head injuries after Tabalong and Tanah Laut Regency in 2007.Objective: The aim of this study was to describe the characteristics of head injury patient and referral number at Dr. H. Andi Abdurrahman Noor general hospital.Methods: All head injury patients admitted to the emergency department (ED) of Dr. H. Andi Abdurrahman Noor general Hospital in a one-year period (2017) were registered in this retrospective study. Using the total population sampling method, 413 cases of head injury during the period were included as a subject of study.Result: This study showed that mild head injury was the most cases of head injury with 325 cases (78.2%). 61 patients were referred to a higher trauma center in 2017. Head injury was most common in 11-20 years old age group. Men also had higher incident rate compared to women (2:1). Most of the patients were a nonstate employee. Head injury is commonly caused by traffic accident.Conclusion: This study shows that characteristics of HI in the peripheries area such Tanah Bumbu regency are no different from other countries. Our findings suggest that several prevention steps should be taken to reduce the number of head injury based on the distribution and characteristics of head injury sustainers.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 236-236
Author(s):  
Yu Ming ◽  
Aleksandra Zecevic ◽  
Richard Booth ◽  
Susan Hunter ◽  
Andrew Johnson ◽  
...  

Abstract Background: The consequences of fall-related injuries are becoming more significant due to ageing societies worldwide. This study aims to provide information on medications prescribed to older adults within one year before they experienced fall-related injury in Ontario, Canada. Methods: A population-based descriptive study of older adults (66 years and older) who experienced fall-related injury was conducted using administrative secondary health care data of Ontario. The percentages of patients prescribed each Anatomical Therapeutic Chemical 4th level medication class and fall-risk increasing drugs one year before their fall-related injuries was summarized. Results: From 2010 to 2014, 288,251 older adults (63.2% females) were admitted to Emergency Department due to fall-related injury, 39.9% were fall-related fractures, 12.6% were head injuries. One year prior to their injury, 48.46% of older adults were prescribed with statins; 35.23% were prescribed with diuretics; 26.84% were prescribed with antidepressants; 25.90% were prescribed with opioids and 16.61% were prescribed with anxiolytics. A higher percentage of females were prescribed with diuretics, antidepressants, and anxiolytics than males. 85 years and older people had higher percentage of prescription of diuretics, antidepressants and antipsychotics than other age group. Discussion: In general, older adults diagnosed with fall-related injuries were prescribed with more opioids, benzodiazepines and antidepressants than other general older adults. There were distinct patterns of prescription medication within each sex and age group (66-74 group, 75-84 group and 85 years and older group). Further association between medications and fall-related injuries need to be established using well-defined cohort studies.


Author(s):  
P.C. Tai ◽  
D.W. Gross

Objective:While the risk of developing seizures following a mild head injury has been reported and is thought to be low, the effect of mild head injury on patients with a pre-existing seizure disorder has not been reported. We present a series of cases where a strong temporal relationship between mild head injury and worsening of seizure frequency was observed.Methods:Five cases were identified and reviewed in detail. Information was derived from clinic and hospital charts with attention to the degree of injury, pre- and postinjury seizure patterns and frequency.Results:One patient has primary generalized epilepsy and four have localization related epilepsy. Prior to the head injury, three of the patients were seizure free (range: two to 24 years). The patients suffered from mild head injuries with no or transient loss of consciousness and no focal neurological deficits. In all cases, the patients experienced a worsening of seizure control within days of the injury. In one case, the patient's seizure pattern returned to baseline one year after the accident, while in the remaining four cases, the patients continue to have medically refractory seizures.Conclusion:A close temporal relationship between mild head injury and a worsening of seizure control was observed in five patients with epilepsy. Although further study is required, this observation suggests that a head injury that would be considered benign in the general population can have serious consequences such as recurrence of seizures and medical intractability in patients with epilepsy.


2014 ◽  
Vol 86 (4) ◽  
pp. 2025-2038
Author(s):  
SYLVIO PÉLLICO NETTO ◽  
FLAVIO R. STEFANELLO ◽  
ALLAN L. PELISSARI ◽  
HASSAN C. DAVID

Generally, the forest companies use the total one year planting area as a minimum stratum of the total population and, consequently, the forest inventory processing has been conducted by applying the stratified random sampling to it. This study was carried out in the National Forest of Tres Barras, Brazil, and it aimed to classify and map the sites of Pinus elliottii stands. A systematic sampling was structured into clusters and applied independently by compartments. The clusters, in maltese cross, were composed of four sampling subunits, using Prodan sampling method with a fixed number of six trees. By analysis of the methodology it was possible to confirm the hypothesis: a) the selective thinning cause expressive increase of volumetric variability within compartments; b) the variation of sites within the compartments causes volumetric expansion of variance and this grows proportionally to the quality of the sites; c) the stratification in sites results in minimum variance within them; d) the stratification in sites resulted in until to 91% reduction of variances within them.


2019 ◽  
Vol 13 (2) ◽  
pp. 136-142
Author(s):  
Amila Amila ◽  
Sariani Sariani

ABSTRACT : LENGTH OF STAY MILD HEAD INJURY IN SARI MUTIARA GENERAL HOSPITAL Background : Early management of  head injury patient in hospital will affect the outcome and length of stay mild head injury patient in the hospital.Purpose : The purpose of this study were to identify the correlation among age, GCS  and hyperglycemia with length of stay in the hospital.Methods :The data obtained was analyzed by correlational analytic with retrospective approach. The sample of this study was recruited with consecutive sampling as 117 people. Data collected by observation from medical record on the mild head injury patients who come to hospital from March 2014 until March 2015 at Sari Mutiara General Hospital Medan. The data was analyzed by pearson and spearman correlation  with significance α <0.05.Results : The study showed that  70.1%  Hyperglicemia, mean of age, GCS and length of stay were 32.09; 13,99 and 3.68 in mild head injury.There was no significantly correlation between age with length of stay (r = 0.163; p > 0.05). Whereas there was significant correlation between GCS and hyperglycemia with length of stay (r=-0.735; r = 0.610 ; p < 0.05)Conclusion : Based on the study, we concluded that the more hyperglycemia, the more severe length of stay in patient with mild head injury.  Keywords: Mild head injury; GCS; Hyperglycemia; Length of stayPendahuluan: Penanganan awal pasien cedera kepala pada saat datang ke rumah sakit akan mempengaruhi outcome serta Length of Stay (LOS) pasien di rumah sakitTujuan : Penelitian ini bertujuan untuk mengetahui hubungan umur, GCS dan hiperglikemia dengan LOS pasien cedera kepala ringan di RSU Sari Mutiara Medan.Metode : Metode penelitian dilakukan secara analitik korelasional dengan pendekatan retrospektif. Teknik sampling dalam penelitian ini menggunakan consecutive sampling dengan jumlah sampel sebanyak 117 orang  yang diambil dari data sekunder yaitu observasi pada catatan medis pasien cedera kepala ringan yang dirawat di RSU Sari Mutiara Medan dalam periode satu tahun (Maret 2014 s.d Maret 2015). Data dianalisis menggunakan uji korelasi Pearson dan Spearman dengan signifikan α <0.05.Hasil Penelitian: Hasil uji menunjukkan 70.1% pasien hiperglikemia, rata-rata umur pasien  adalah 32.09 tahun, rata-rata GCS dan lama rawat pasien cedera kepala ringan adalah 13,99 dan 3.68 hari. Hasil uji menunjukkan tidak ada hubungan antara umur dengan LOS pasien cedera kepala ringan dengan nilai p=0,080 dengan kekuatan korelasi r = 0,163. Hasil uji didapatkan hubungan yang signifikan antara GCS dan hiperglikemia dengan LOS pasien cedera kepala ringan (p=0,000) dengan kekuatan korelasi (r=-0.735; r= 0,610).Simpulan : Hal ini menunjukkan bahwa semakin tinggi hiperglikemia, maka semakin tinggi LOS pasien cedera kepala.


Author(s):  
Kana Ram Patel ◽  
Jagdish Jugtawat ◽  
Shalender Kumar ◽  
P.C. Vyas

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.


2017 ◽  
Vol 3 (2) ◽  
Author(s):  
Nanang Bagus Sasmito ◽  
Titin Andri Wihastuti ◽  
Heri Kristianto

Abstract : Head injuries will affect more serious disorder compared with other organ traumatic. Lack of nurse competences, particularly on identify the early sign of critical head injuries and misunderstood of onset head injuries happened with the patient, will cause delays to give precise treatment and decision for the patient, such as giving reference to other hospital. The objective of this study is to analyze the influencing factor related to outcome of head injury patient in RSUD dr. Iskak Tulungagung using Interpersonal Interpersonal Nursing Model by Heldegrad E. Peplau approach. This research used analytical analytics comparative with cross-sectional approch. The data collected by purposive sampling and finally 78 respondent were included in this research. With regard to outcome of head injury patient whose referenced in, the bivariat analysis result showed conditions patients a head injury (p-value 0,005), assistance referral (p-value 0,042), the distnace referral (p value 0,020), and time referral (p value 0,006). In addition, the regression analysis showed variable pattients condition the most dominant relating to outcome patients a head injury referred (p value 0,001 and OR 16.184). The decrease of GCS value for patients who reference at other hospital indicated the deterioration of their condition. Hence, the values of GCS was important indication to be noticed.When in every phase in interpersonal nursing implementation well in patients referred to a head injury, so outcome head injuries with the glasgow outcome scale would be good.Key Word : Outcome Patient Head Injuries, Referrals, Interpersonal Nursing. Abstrak : Cedera kepala akan memberikan gangguan yang sifatnya lebih kompleksbila dibandingkan dengan trauma pada organ tubuh lainnya. Minimnya kompetensi yang dimiliki perawat dalam mengenali tanda dini kegawatan cedera kepala dan tidak memahami onset cedera kepala yang dialami oleh korban memberi dampak pada keterlambatan tindakan segara yang harus diberikan kepada pasien cedera kepala, salah satunya dalam membuat keputusan rujukan.Beberapa hal yang dapat mengurangi dampak dari pelaksanaanrujukan pasien yang tidak optimal, perlu disusun manajemenrujukan pasien gawat darurat yang berfungsi sebagai kerangka acuan bagi petugas kesehatan terlebih lagiperawat. Salah satu teori model keperawatan yang menunjang dan mengembangkan pelaksanaan rujukan adalah teori interpersonal relations in nursingdari Heldegard E Peplau. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan outcome pasien cedera kepala yang dirujuk di IGD RSUDdr. Iskak Tulungagung melalui pendekatan model interpersonal nursing Heldegrad E. Peplau. Metode dalam penelitian ini adalah analitik komparatif dengan pendekatan cross-sectional. Jumlah sampel sebanyak 78 responden dengan menggunakan purposive sampling. Dari analisis bivariat faktor yang berhubungan dengan outcome pasien cedera kepala yang dirujuk adalah tingkat kesadaran pasien cedera kepala (p value 0,005), pendampingan saat merujuk (p value 0,042), jarak rujukan (p value 0,020) dan faktor waktu yang ditempuh (p value 0,006). Hasil analisis uji regresi logistik menunjukkan faktor kondisi pasien yang paling dominan berhubungan dengan outcome pasien cedera kepala yang dirujuk (p value 0,001 dan nilai OR 16.184). Pasien cedera kepala mengalami penurunan nilai GCS pada saat dirujuk merupakan petunjuk bahwa terjadi perburukan kondisi pasien, sehingga nilai GCS menjadi parameter yang penting utnuk diperhatikan. Sehingga apabila dalam setiap fase dalam interpersonal nursing dapat dilaksanakan dengan baik pada pasien cedera kepala yang dirujuk, maka outcome cedera kepala dengan penilaian glasgow outcome scale akan baik.Kata Kunci : Outcome Pasien Cedera Kepala, Rujukan, Interpersonal Nursing.


2018 ◽  
Vol 2 (2) ◽  
pp. 280
Author(s):  
Normi Parida Sipayung ◽  
Henny Syapitri

Introduction. Early management of head injury patient in Emergency Department will affect the outcome and Length of Stay mild head injury patient in the hospital. The research aimed to analyze GCS as predictor factors associated Length of Stay patient in the hospital. Methods. This study was correlational analytic approach with cross sectional. Technique sampling in this study used purposive sampling. The number of samples used 41 patient were taken from the primary data which doing the observations on the mild head injury patients who come to emergency department from April until June 2014 at Pirngadi General Hospital Medan. Data was collected by observation and questionnaire. Result. The results of the analysis used Spearman test showed that there was correlation between GCS with Length of Stay of mild head injury patients p 0.00, r -0,637. Discussion. Higher value of GCS So length of stay a mild head injury patients in Pirngadi General Hospital Medan also shorter .Keywords: Mild head injury, outcome head injury, predictor Length of Stay, Emergency Department


2018 ◽  
Vol 5 (10) ◽  
pp. 3252
Author(s):  
Vinod Pusdekar ◽  
Sandeep Ambedkar ◽  
Ritesh Bodade

Background: Head injury can be defined as trauma in which the head is struck or moves violently, resulting in transient or permanent alteration of consciousness of an individual. We profiled and analyzed the cases of head injuries reporting to a government hospital a rural Indian setting.Methods: All the patients with history of antecedent head injury were firstly assessed by detailed history, with emphasis on history of unconsciousness/vomiting/convulsions/ENT bleed. Then a thorough clinical examination was undertaken, including Glasgow Coma Scale (GCS) scoring. Further, all the patients were subjected to CT scan of head for correlation of clinical findings, confirmation of diagnosis, delineation of extent of disease and suitability of operative intervention etc.Results: Majority of the patients belonged to 15-44 years age group (30, 60%) and were males (38, 76%). Road traffic accidents accounted for majority (38, 76%) of the cases. GCS score was found to range between 13-15 (mild) in 18 (36%) patients, 9-12 (moderate) in 21 (42%) patients and 3-8 (severe) in 11 (22%) patients. Best recovery (88%) was shown by patients of GCS score between 13-15. Among the critical symptoms and signs, unconsciousness and abnormal plantar reflex were the commonest ones. Generalized cerebral edema without associated lesion (50%) was the commonest finding followed by extradural hematoma (EDH) (40%) on CT scan of head. As for recovery w.r.t. CT scan findings, highest rate of recovery (100%) was reported in patients with fracture without intracranial pathology, while highest mortality was reported in those having mixed lesion (90%).Conclusions: Road traffic accidents in young age group is the commonest mode of head injury and GCS score is a good predictor of recovery in head injury cases.


1977 ◽  
Vol 22 (2) ◽  
pp. 129-132 ◽  
Author(s):  
S. Galbraith ◽  
W. R. Murray ◽  
A. R. Patel

A prospective study of head injury admissions to a city teaching hospital over one year has shown that most were minor. Of the 918 patients, 85 per cent were discharged within 48 hours, only 3 per cent required definitive neurosurgical care, and the overall mortality was 2 per cent. Most cases came to hospital after 5.00 p.m. especially at the weekend. Head injuries accounted for almost one-third of emergency admissions to male general surgical wards.


2020 ◽  
Vol 8 (1) ◽  
pp. 64-68
Author(s):  
Anil Kumar Bansal ◽  
Anil Kumar Gupta

Background: Head injury is defined as an impairment in brain function as a result of mechanical force. The dysfunction can be temporary or permanent, and may or may not result in underlying structural changes in the brain. Head injuries are a major public health problem worldwide. A limited amount of neurological damage occurs at the time of impact (primary injury). Subjects and Methods: The study was a prospective observational study took place in the Department of Radiology, over a 8 month period which involves all type of head injuries. Informed consent was obtained by the subjects who participated in the study. All head injury patients attending the emergency department were included, while those with no clear history of trauma as the primary event and neurologic deficit that could not be explained by head trauma were excluded. Results:  A total of 1000 patients underwent CT for a head injury. Table 1 shows baseline characteristics as age, gender, referred cases, type  of injury, mode of injury and clinical features where we observed 48.2% cases were in the age group between 21-40 years with 80% of male subjects. While observing for the mode of injury, we found most of the cases falls in the category of road traffic accidents (77%) with external injury (83.5%) and loss of consciousness (63.4%) as highly observed clinical features. Conclusion: This study showed a significant association of overall CT positivity with patients sociodemographic and clinical factors such as: male gender, elderly age group (>60 years), history of alcohol consumption, LOC >5 min, history of vomiting, history of seizures, evidence of ear bleed, evidence of nosebleed, and GCS 12 (moderate and Severe head injury). From the results of this study, we recommend the following indications for doing CT in head injury patients: (1) CT is indicated in all patients with moderate and severe head injury (GCS ≤12).


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