Aggressive management of severe closed head trauma: time for reappraisal

Lancet. 1989 Aug 12;2(8659):369-71. doi: 10.1016/s0140-6736(89)90546-1.


The records of 187 patients (age 6 months to 82 years) who sustained severe closed head injuries and were admitted to a neurosurgical unit between 1983 and 1987 were retrospectively reviewed. The aim was to develop a scale for selecting patients whose death could be predicted with certainty at an early stage and who should therefore not receive prolonged intensive care. The scale was prospectively tested on 52 comparable patients admitted during 1988 and was found to be accurate with no falsely pessimistic predictions. The score is based mainly on clinical observations within 12 h of presentation.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Craniocerebral Trauma / mortality
  • Craniocerebral Trauma / therapy*
  • Critical Care
  • Evaluation Studies as Topic
  • Humans
  • Infant
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Wounds, Nonpenetrating / mortality
  • Wounds, Nonpenetrating / therapy*