Head and neck trauma: Profile and factors associated with severe head injury

Abstract

Background: Head and neck trauma is an increasing cause of morbidity and mortality in India. The mode of trauma has varies with geographical progress and it is important to understand the factors associated with severe head injury among this cohort. Methods: This was a retrospective observational study of all adult trauma patients with head and neck trauma presenting to our emergency department (ED). Details of the incident, injuries and outcome were analyzed. Results: During the 3-month study, the ED attended to 16,169 patients with 2022 being trauma victims. Among them, 51.4 3% (n = 835) adults who sustained head, face or neck trauma and hence were included in the final analysis. Overall, RTA s were the predominant mode of injury (81.2% (n = 678), followed by fall on level ground (6.5%; n = 54), fall from height (5.1%; n = 43) and assault (3.7%; n = 31). A history of consuming alcohol prior to the incident was obtained in 16.2% (135) of the patients. Head, face, and neck injuries were seen in 74.9% (n = 626), 64.1% (n = 536), and 4.9% (n = 41) of patients respectively. Bivariate analysis showed male sex (90.3% vs. 76.8%; unadjusted odds ratio [OR]: 2.81, 95% confidence intervals [CI]: 1.19–6.64; P = 0.018) and pedestrian injuries (19.4% vs. 8.5%; unadjusted OR: 2.57, 95% CI: 1.30–5.07; P = 0.006) to have a statistically significant association with sustaining severe head injury. Conclusion: Head and neck trauma comprises a significant proportion of patients with trauma with RTA and falls being the most common causes. Among patients with head and neck trauma, males and pedestrians have an increased odds of sustaining severe head injury (Glasgow Coma Scale ≤8).