Outcome in 1,000 head injury hospital admissions: the Athens head trauma registry

J Trauma. 2008 Oct;65(4):789-93. doi: 10.1097/TA.0b013e3181469e26.

Abstract

Background: The aim of this study was to establish a head trauma registry to (a) examine demographics, etiology, severity, clinical course, and outcome; (b) compare results with previous published series; (c) identify causes of bad outcomes; and (d) propose methods to improve therapy and prognosis.

Methods: The following data were collected on 1,000 consecutive victims with head injury over 14 years of age admitted during a 4-year period: demographic characteristics, cause of injury, clinical variables, neuroimaging, therapy data, and outcome in 6 months.

Results: Seventy-four percent were men, and mean age was 43 years. Seventy-one percent suffered injuries due to road crashes, 14% due to alcohol, and 2% due to substances. The secondary transfer rate was 49%. For severe injuries, the time intervals from incident to hospital and subsequently to neurosurgical unit were 35 minutes and 4 hours, respectively. In 65% and 72% of cases, there was no record of preresuscitation hypoxia or hypotension, respectively, whereas suspected or definite episodes of hypoxia and hypotension were 27% and 13%, respectively. Most cases were mild trauma (63%), the remaining were severe (26%) and moderate (11%) injuries. Severe systemic trauma coexisted in 18%. Cranial surgery rate was 19% and it increased to 39% in severe trauma. The 6-month overall good outcome was 71%, with lower rates in moderate (58%) and severe (24%) injuries.

Conclusions: The organization of Greece's first head injury registry offered an important preliminary core data concerning brain trauma etiology, management, and long-term outcome.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Cause of Death*
  • Craniocerebral Trauma / diagnosis
  • Craniocerebral Trauma / epidemiology*
  • Craniocerebral Trauma / therapy
  • Female
  • Glasgow Coma Scale
  • Greece / epidemiology
  • Hospital Mortality / trends*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Incidence
  • Injury Severity Score
  • Male
  • Middle Aged
  • Patient Admission / statistics & numerical data
  • Registries*
  • Sex Distribution
  • Survival Analysis
  • Urban Population