Abstract
In today's Lancet, H Patel and colleagues1 report their study of 176 467 patients with blunt trauma from England and Wales between 1989 and 2003, in which they found a ten-fold higher mortality in patients with head injury (of any severity) than in those without. In a subset of nearly 700 patients with severe head injury in the UK between 1996 and 2003, they found a 26% increase in mortality and a 2·15-fold increase in the case-mix-adjusted odds of death for patients treated in non-neurosurgical centres compared with those treated in neurosurgical centres.
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