scholarly journals Blunt Chest Injury: epidemiological profile and determinant of mortality

2018 ◽  
Vol 5 (5) ◽  
pp. 1622
Author(s):  
Kelechi E. Okonta ◽  
Emmanuel O. Ocheli
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Formal Education ◽  
Injury Severity ◽  
Chest Injury ◽  
P Value ◽  
Chest Injuries ◽  
Tertiary Hospitals ◽  
Epidemiological Profile ◽  
A Prospective Study

Background: The identification of the epidemiological profile and the determinants of mortality for blunt chest injuries (BCI) ensures the proper documentation of susceptible patients, and the implementation of strategies for prompt and improved patients’ care.Methods: This is a prospective study for a 4-year period at two tertiary hospitals in Nigeria. The inclusion criteria were patients who had BCI, did chest radiograph and admitted for treatment. The statistical software for analysis was SPSS version 22 and using Pearson’s X2 and spearman’s X2 for correlation of mortality with the Injury Severity Score (ISS), Glasgow Coma Scale(GCS) and Hemi-thorax affected. The p-value was significant at <0.001.Results: I One-hundred and twenty-six (52.3%) of 241 patients had BCI, the average age was 40.4years with a range of 0.8-79years.There were 104 (82.5%) male with a ratio of 4.7:1. Most patients 86(68.3%) were between 19-59 years of age, 85 (67.5%)were unskilled workers and 57 (45%) had no formal education. Most 66.7% of the injuries occurred in the first half of the year with a peak (16.3%) in March. Mondays and Fridays,and, morning hours were the peak periods. BCI was by motor vehicular accidents 94 (74.6%), falls 28 (22.2%), and other causes 4 ((3.2%). The associated injuries were extremities 25(19.8%,), cranio-spinal injuries 17(13.5%) and blunt abdominal injuries13 (10.3%). Eleven (8.7%) patients died within one-month of admission. The determinants of mortality were high ISS (p<0.001), severe head injury (p<0.001) and bilateral chest injury (p<0.001).Conclusions: The contribution of falls to BCI is on the increase with BCI occurring at periods of increased activities like Mondays, Fridays and morning hours.The determinants of mortality were high  ISS ,severe head injury and bilateral chest injury.

scholarly journals Comparison of Lymphocyte Neutrophil Ratio in Head Injury Patients with Blood and without Intracranial Bleeding in Dr. M. Djamil Hospital

2021 ◽  
Vol 7 (1) ◽  
pp. 164-180
Author(s):  
Muhammad Zaki Abdul Hafiz ◽  
Syaiful Saanin ◽  
Hesty Lidya Ningsih
Keyword(s):  
Head Injury ◽  
Intracranial Hemorrhage ◽  
Severe Head Injury ◽  
Injury Severity ◽  
Intracranial Bleeding ◽  
P Value ◽  
Mild Head Injury ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
The Mean

A B S T R A C TBackground: Head injuries occur every 15 seconds worldwide, with patientsdying every 12 minutes. The value of the Neutrophil Lymphocyte Ratio (NLR) is afactor that influences the assessment and prognostic value of patients withintracranial hemorrhage and without intracranial hemorrhage in head injury.The aim of this study was to determine the relationship between increased NLRbased on the severity of head injury patients with or without intracranialhemorrhage. Methods: This study is a retrospective cross sectional study of headinjury patients with hemorrhage and without intracranial hemorrhage who weretreated at Dr. M. Djamil Hospital Padang in 2020 from May to December 2020.Data was collected in the Medical Records Department of Dr. M. Djamil HospitalPadang who met the inclusion and exclusion criteria. Results : A total of 92patients were included in the inclusion criteria for this study. The results showedthat the mean NLR value in head injury patients was 11.72 with a variation of7.31. The mean NLR level based on the severity of mild head injury was 10.15with a variation of 6.38. The mean NLR level of moderate head injury severity was12.70 with a variation of 7.09. The mean NLR level of severe head injury, was14.69 with a variation of 9.30. The results showed that there was no difference inthe mean of NLR levels in mild head injury patients with hemorrhage and withoutintracranial hemorrhage. The results showed that there was a significantrelationship between NLR levels in moderate head injury patients withhemorrhage (14.20) and without intracranial hemorrhage (7.20) (p value = 0.029),whereas in severe head injury it could not be assessed because there was nosample without hemorrhage. Conclusion: There is an association betweenincreased NLR and intracranial bleeding in moderate head injury patients

Acute Diabetes Insipidus in Severe Head Injury: A Prospective Study

2008 ◽  
Vol 207 (4) ◽  
pp. 477-484 ◽  
Author(s):  
Pantelis Hadjizacharia ◽  
Elizabeth O. Beale ◽  
Kenji Inaba ◽  
Linda S. Chan ◽  
Demetrios Demetriades
Keyword(s):  
Head Injury ◽  
Prospective Study ◽  
Diabetes Insipidus ◽  
Severe Head Injury ◽  
Acute Diabetes ◽  
A Prospective Study

Global outcome, productivity and epilepsy 3—8 years after severe head injury. The impact of injury severity

2008 ◽  
Vol 22 (7) ◽  
pp. 653-662 ◽  
Author(s):  
Toril Skandsen ◽  
Tom Ivar Lund ◽  
Oddrun Fredriksli ◽  
Anne Vik
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Injury Severity ◽  
The Impact

Mortality Outcome of Emergency Decompressive Craniectomy and Craniotomy in the Management of Acute Subdural Hematoma: A National Data Analysis

2020 ◽  
pp. 000313482095146
Author(s):  
Nasim Ahmed ◽  
Patricia Greenberg ◽  
SeungHoon Shin
Keyword(s):  
Head Injury ◽  
Hospital Mortality ◽  
Decompressive Craniectomy ◽  
Subdural Hematoma ◽  
Severe Head Injury ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Univariate Analysis ◽  
Acute Subdural Hematoma ◽  
Significant Difference

Background The purpose of the study is to evaluate the in-hospital mortality of patients who presented with acute subdural hematoma (SDH) and underwent emergency decompressive craniectomy (DC) or craniotomy (CO) within 4 hours of hospital arrival. Method The National Trauma Data Bank (NTDB) dataset of the calendar year of 2007 through 2010 was accessed for the study. All blunt severe head injury patients who presented with acute SDH were included in the study. Severe head injury is defined as a head Abbreviated Injury Scale (AIS) score ≥3 and a Glasgow Coma Scale (GCS) score ≤8. Univariate followed by propensity-matched analyses were performed to compare the two procedure groups: DC and CO. Results Out of 2370 patients, 518, (21.9%) patients underwent DC. There were significant differences found in the univariate analysis between the DC and CO groups for median age (38 (IQR: 22.0, 55.0) vs 49 (IQR: 27, 67), P < .001), mechanism of injury (fall: 33.2% vs 50.7%; motor vehicle crashes: 58.3% vs 40.9%, P < .001), and median injury severity score (ISS: 26.0 (IQR: 25, 38) vs 26 (IQR: 25.0, 33.0), P < .001). After propensity score matching and pair-matched analysis, no differences were found with any of the above characteristics. The pair-matched analysis also showed no significant difference in in-hospital mortality (42.7% vs 37.5%, P = .10) between the DC vs CO groups. Conclusion The overall in-hospital mortality for emergency CO or DC for the evacuation of SDH remains high. The preference of one operative procedure over the other did not impact overall mortality.

scholarly journals Prevalence of Head Injury of Patients Arriving in a Tertiary Care Center

2020 ◽  
Vol 2 (1) ◽  
pp. 38-41
Author(s):  
Arbindra Kumar Yadav ◽  
Jagat Narayan Rajbanshi ◽  
Saroj Kumar Kushwaha ◽  
Pankaj Raj Nepal
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Care Center ◽  
Tertiary Care ◽  
Emergency Admission ◽  
P Value ◽  
Cross Sectional ◽  
Severity Of Injury

Background and purpose: The prevalence of head injury is increasing with increasing number of automobiles, especially motorbike. With the objective to evaluate the prevalence of head injury and factors that could affect the severity of head injury, this study was performed in a tertiary hospital at far- eastern Nepal. Methodology: This is a cross-sectional study over the duration of one year. Association of age, gender, and mode of injury was checked with severity of injury using Chi-square test where P-value was kept significant at <0.01. Result: Total numbers of patient admitted through the emergency department, during the study period, were 832. Mean age of patient in the study group was 34.59 (SD 18.92) years. Majority of them falls in the category of 20-29 years. Among the different categories of head injuries, mild head injury (76%) was the most common presentation followed by moderate head injury and severe head injury, which were 14% and 10% respectively.  Conclusion: Head injury seems to be the major cause of emergency admission in for eastern part of Nepal. Among them road traffic accidents seems to be the major burden which is more common in young gentlemen with significant number of severe head injury.

Dynamic autoregulatory response after severe head injury

2002 ◽  
Vol 97 (5) ◽  
pp. 1054-1061 ◽  
Author(s):  
Roman Hlatky ◽  
Yu Furuya ◽  
Alex B. Valadka ◽  
Jorge Gonzalez ◽  
Ari Chacko ◽  
...  
Keyword(s):  
Blood Flow ◽  
Head Injury ◽  
Severe Head Injury ◽  
Content Type ◽  
Factors Affecting ◽  
Physiological Variables ◽  
End Tidal ◽  
A Prospective Study ◽  
Pressure Autoregulation ◽  
Fine Print

Object. The purpose of this study was to evaluate the extent and timing of impairment of cerebral pressure autoregulation after severe head injury. Methods. In a prospective study of 122 patients with severe head trauma (median Glasgow Coma Scale Score 6), dynamic tests of pressure autoregulation were performed every 12 hours during the first 5 days postinjury and daily during the next 5 days. The autoregulatory index ([ARI] normal value 5 ± 1.1) was calculated for each test. The changes in the ARI over time were examined and compared with other physiological variables. The ARI averaged 2.8 ± 1.9 during the first 12 hours postinjury, and continued to decrease to a nadir of 1.7 ± 1.1 at 36 to 48 hours postinjury. At this nadir, in 87% of the patients the value was less than 2.8. This continued deterioration in the ARI during the first 36 to 48 hours postinjury occurred despite an increase in cerebral blood flow ([CBF], p < 0.05) and in middle cerebral artery blood flow velocity ([BFV], p < 0.001), and could not be explained by changes in cerebral perfusion pressure, end-tidal CO2, or cerebral metabolic rate of O2. A marked decrease in cerebrovascular resistance ([CVR], p < 0.001) accompanied this deterioration in the ARI. Patients with a relatively higher BFV on Day 1 had a lower CVR (p < 0.05) and more impaired pressure autoregulation than those with a lower BFV. Conclusions. The inability of cerebral vessels to regulate CBF normally may play a role in the vulnerability of the injured brain to secondary ischemic insults. These studies indicate that this vulnerability continues and even increases beyond the first 24 hours postinjury. Local factors affecting cerebrovascular tone may be responsible for these findings.

scholarly journals Chest trauma in the older people: epidemiological profile and treatment outcome

2018 ◽  
Vol 5 (8) ◽  
pp. 2697
Author(s):  
Kelechi E. Okonta ◽  
Emmanuel O. Ocheli
Keyword(s):  
Older Persons ◽  
Chest Trauma ◽  
Injury Severity ◽  
Rib Fracture ◽  
Chest Injury ◽  
Thoracic Injury ◽  
Associated Injury ◽  
Severity Scores ◽  
Epidemiological Profile ◽  
Neurological Injuries

Background: There has not been any documented account of chest trauma among the older persons in Nigeria. The aim is to determine the epidemiological profile of chest injury in the old population.Methods: A prospective study of all the patients with chest trauma in two Nigeria tertiary hospitals for 4 years period. The bio-data, cause and type of chest injury, time between injury and presentation in the hospital, number of rib fractures, associated injury, injury severity score (ISS), treatment and outcome were analyzed using range and mean.Results: A total of 38(15.8%) older persons of 241 patients with chest trauma were analysed. Twenty-two (57.9%) patients were male with most of the patients being farmers and unskilled workers. Twenty-four (63.2%) patients sustained chest injury from motor vehicular crash while 10(26.3%) patients were from falls,2(5.3%) patients from gunshot injury and 2(5.3%) patients from other causes. The time between injury and presentation to the hospital ranged from 30-minutes to 5-days. Twenty-seven patients (71.1%) had rib fracture. The associated injuries were limb bone injuries in 10 (26.3%) patients, blunt abdominal injuries in 2(5.3%) patients and neurological injuries in 4 (10.6%) patients. The treatment in 35 (92.1%) patients was at least by chest tube insertion. The 30-day hospital mortality was 3(7.9%) from patients with injury severity scores of 32, 41 and 48 respectively.Conclusions: Traumatic chest injury in the older persons is still not common. Trauma to the limb bones was the commonest associated injury, and rib fracture was the commonest thoracic injury encountered. However, expeditious management led to reduced mortality recorded in this study.

scholarly journals CORRELATION BETWEEN RESPIRATORY FREQUENCY (RR) AND OUTCOME IN HEAD INJURY PATIENTS IN EMERGENCY ROOM OF BANGIL HOSPITAL, PASURUAN DISTRICT

2018 ◽  
Vol 7 (2) ◽  
pp. 148-151 ◽  
Author(s):  
Ida Zuhroidah ◽  
Ayu Dewi Nastiti ◽  
Nurul Huda ◽  
Novi Rahmania
Keyword(s):  
Nursing Education ◽  
Head Injury ◽  
Injury Severity ◽  
Head Injuries ◽  
Sampling Technique ◽  
Respiratory Frequency ◽  
P Value ◽  
Secondary Brain Injury ◽  
Cross Sectional ◽  
Spearman Test

Background: Head injuries are a major cause of disability and death under the age of 45 years. The main focus on handling head injury patients is to prevent and limit the occurrence of secondary brain injury which will ultimately affect the outcome of the sufferer. Emergency conditions in head injury patients certainly require quick and appropriate help for better outcome outcomes.Purpose: The purpose of this study was to determine the relationship of respiratory frequency with the outcome of head injury patients in the emergency department of Bangil Hospital Pasuruan Regency.Methods: This research method is quantitative with a cross sectional approach involving 53 respondents. The sampling technique uses purposive sampling method. The outcome of head injury patients was measured using the Trauma and Injury Severity Score (TRISS) scale.Results: Data were analyzed using the Spearman test which showed a relationship p value = 0.013 <α = 0.05 so that H0 was rejected or there was a significant relationship between respiratory frequency (RR) and the outcome of head injury patients.Conclusion: The need for improvement and development of nurse resources through nursing education, emergency training and evaluation of health services at the ED. Keywords: Head Injury, Respiratory Frequency (RR), Outcome.

Sign in / Sign up

Export Citation Format

Share Document