Outcome of severe head injury management: A study in a tertiary care hospital

Abstract

Introduction: Head injury continues to be a great challenge not only for the public but also for the neurosurgeon. India has the distinction of having the highest rate of head injury in the world. In Bangladesh head injury is a headache for the surgeon. Aim of the study: The aim of this study was to assess the several steps and final outcome of severe head injury patient management. Materials and Methods: This was a prospective observational study of severe head injury patients admitted in the Department of Medicine, Sheikh Sayera Khatun Medical College, Gopalgonj, Bangladesh during the period from January 2018 to December 2018. A total of 86 severe head injury patients of all age groups were admitted and treated. In all cases; age, sex, mechanism, severity, other associated injuries, computed tomography (CT) findings, management, and Glasgow outcome scale were analyzed. Results: In this study among 86 participants 67 (78%) were male and 19 (22%) were female. On the other hand, as final outcome we found death was 31.40% (n=27), persistent vegetative state was 3.49% (n=3), severe disability was 5.81% (n=5), moderate disability was 3.49% (n=3) whereas the ‘good recovery’ was 55.81% (n=48). Conclusion: Generally outcome of head injury depends on initial presentation. Early recognition and prompt management contribute to decrease mortality as well as disability of patients. CT-scan facility in district hospitals and upazilla health complexes; early referrals of head injury patients to higher centers and neurosurgical intensive care can decrease the mortality in head injuries.