Attendance of patients with minor head injury in an emergency department observation ward.

Abstract

A retrospective study was undertaken to compare the management of head injured patients in a short stay ward (SSW) with their management in other departments in the same hospital, where there is no neurosurgery department. Head injured patients were admitted to the general surgery department until November 1998, when the SSW was inaugurated. The following data were collected for all head injured patients admitted between 1997 and 1999: age, gender, diagnosis, outcome categories and length of stay. A total of 225, 238 and 340 head injured patients were admitted in 1997, 1998 and 1999 respectively. Patients in the neurology department were older (60 +/- 23 years) than in the SSW (41 +/- 23 years) and general surgery department (42 +/- 20 years). Patient diagnosis was similar in the SSW, paediatrics and general surgery departments but patients admitted to the neurology department had more skull fractures and intracranial injuries. The length of stay was longer in general surgery (3.5 +/- 3.9 days) and neurology departments (9.6 +/- 19.1 days) than in the SSW (1.4 +/- 0.8 days) and paediatrics department (1.5 +/- 1.5 days). Thirteen patients in the SSW required admission to another department in the hospital and only one was transferred to the neurosurgery department in another hospital. The results support the view that SSWs are suitable in the management of head injured patients.