Effect of using a head injury fast-track system on reducing the mortality rate among severe head injury patients in Southern Thailand: A retrospective study with historical control.

Abstract

Context:Head injuries are the leading cause of traumatic morbidity and mortality. Timely proper management can reduce the mortality rate.Aims:This study aimed to examine the effects of a fast-track system on reducing head injury mortality using the data in Southern Thailand.Settings and Design:A retrospective study of data from the medical records of severe head injury patients admitted to Hatyai Hospital from October 2012 to May 2017.Subjects and Methods:The records of subjects were selected for participants aged more than 11 years, having Glasgow Coma Score (GCS) <9, no injuries in other organs, and neither hypoxemia nor hypotension. A total of 193 participants fulfilling these criteria were analyzed. Of these, 108 participants were managed in the fast track.Statistical Analysis Used:The fast-track group was compared with normal track participants by using logistic regression after preliminary analysis to identify the risk factors using the Chi-squared tests.Results:After adjustment for confounders, namely acute subdural hematoma, linear skull fracture and diffuse brain injury, and mortality in the fast-track group (13%) was significantly lower than that in the nonfast track group (22.4%).Conclusions:Using the fast-track system can reduce mortality from severe head injuries and should be implemented in the health services system.