EXPERT ASSESSMENT OF DIAGNOSTIC DEFECTS IN TRAUMATIC BRAIN INJURY WITH DAILY FATALITY RATES DEPENDING ON THE DURATION OF TREATMENT AND PATIENTS' HOSPITAL STAY

Abstract

One common diagnostic error in traumatic brain injury (TBI) assessment is the failure to recognize and properly evaluate the initial injury. The aim of our study was to find out diagnostic defects in traumatic brain injury with daily fatality rates depending on the duration of treatment and patients' hospital stay by analyzing the medical records of patients in Kyiv City Clinical Emergency Hospital. 102 cases of fatalities that occurred within 24 hours after admission to KCCEH (2012-2019 years) in cases of TBI were analyzed. Medical histories of the deceased and data from the forensic autopsy had been analyzed. It was found that the highest number of defects in diagnostic procedures, such as the absence of a complete description of the local status of head injuries, the lack of comprehensive assessment and objectification of hemodynamics and respiratory function, and the absence of neurovisualization, were found among patients who stayed in the hospital for up to 3 hours. There was a higher percentage of cases with discrepancies in diagnoses between forensic medical workers and clinicians as the duration of patients' hospital stay increased. The departments where the highest number of deaths occurred varied based on the duration of stay and treatment. The neurosurgical department had the highest number of deaths with a duration of 6 to 12 hours, while the polytrauma department had the highest number of deaths within the first 3 hours. The neurological department had the highest number of deaths with a duration of stay in the hospital from 6 to 12 hours.