Head Injury Mortality Research Articles

Impact of the COVID-19 Pandemic on Mortality of Abusive Head Injury in Children Under One Year Old in Brazil

Impact of the COVID-19 Pandemic on Mortality of Abusive Head Injury in Children Under One Year Old in Brazil

Pattern and Impact of gunshot injuries in Najran region, Saudi Arabia

Background and Aims: Gunshot injuries are common in war zones. This study retrospectively looks at the pattern of gunshot injuries presented to a tertiary care hospital in war zone. Methods: A retrospective analysis of data was carried out for 239 patients treated at King Khalid Hospital, Najran Saudi Arabia, for gunshot injuries from April 2016 to December 2017. The demographic data, anatomical site of gunshot injury, type of injury, and clinical outcome were analyzed. Results: The most affected age group was 16–35 years, while the most common site of injury was the lower extremities. War injuries accounted for 71% and civilian assaults for 29%. Wounds with inlet and outlet accounted for 55%, while injuries with only inlet wounds were 45%. The mortality rate was 7.9%, out of which the patients with head injuries had the highest mortality. There was a statistically significant positive relationship between head injury site and mortality (p < 0 .001), association between head injury site and penetration status (p = 0.006, as well as head injury site and nationality (p = 0.001). Conclusions: Findings reveal pattern of gunshot injuries in war zone consistent with the reported literature. Complete treatment and rehabilitation of patients with such injuries in active war zone can strain the tertiary care facilities

Epidemiology of head injury in a tertiary care hospital in south India

Introduction: The annual incidence of traumatic brain injury is around 28-70 million in the world which causes morbidity and mortality. In India, around 1 million suffer from severe head injury and the mortality rate is around 1 lakh per year. As time progresses there is an observable increase in rates of Head injuries. This study focuses on the epidemiology of traumatic head injury in a tertiary care centre (Madras Medical College, Chennai- India) Materials and methods: This study is a prospective study covering all head injury cases admitted from January 2022 – December 2022 in our tertiary care centre. These patients are treated according to the protocol of the Institute of Neurosurgery. This study covers the management, discharge and follow-up of these patients. Results: The total number of patients admitted with head injuries from January 2022 to December 2022 was 2061. Among them, RTA tops head injury mortality and morbidity. Among RTA, Two-wheeler-associated injuries were most common. Drunken driving, and not wearing helmets and protective gear played a vital role in head injuries. Conclusion: Primary prevention can be the key to reducing the national burden of head injuries.

Predictors of Outcome in Management of Paediatric Head Trauma in a Tertiary Healthcare Institution in North-Central Nigeria.

Trauma is a leading causes of death and disability in all ages. The aim of this study was to describe the demography and characteristics of paediatric head trauma in our institution and examine the predictors of outcome and incidence of injury related mortality. We examined our institutional Trauma Registry over a 2 year period. A total of 1100 trauma patients were seen over the study period. Of the 579 patients who had head injury 99 were in the paediatric age group. Of the paediatric head trauma patients 79 had documented Glasgow coma score (GCS), 38 (48.1%), 17 (21.5%) and 24 (30.4%) had mild, moderate and severe head injury respectively. The percentage mortality of head injury in the paediatric age group was 6.06% (6/99). There is an association between mortality and GCS (p=0.008), necessity for intensive care unit (ICU) admission (p=0.0001), associated burns (p=0.0001) and complications such as aspiration pneumonia (p=0.0001). The significant predictors of outcome are aspiration (p=0.004), the need for ICU admission (p=0.0001) and associated burns (p=0.005) using logistic binary regression. During the study period 46 children underwent surgical intervention with extradural haematoma 16 (34.8%), depressed skull fracture 14 (30.4%) and chronic subdural haematoma five (10.9%) being the commonest indication for surgeries. Paediatric head injury accounted for 9.0% (99/1100) of all trauma admissions. Majority of patients had mild or moderate injuries. Burns, aspiration pneumonitis and the need for ICU admission were important predictors of outcome in children with traumatic brain injury.

The Correlation between Revised Trauma Score (RTS) and Head Injury Mortality in the Emergency Room

Revised Trauma Score (RTS) is an assessment of the human physiological system as a whole. The use of the RTS method in the IGD Harapan Insan Sendawar Hospital has not been optimally implemented. This study aims to determine the relationship between RTS and head injury mortality. The type of research used is quantitative research, using a correlation analytic design with a cross sectional approach to 30 respondents. Sampling by nonprobability sampling with total sampling technique. Data collection using the RTS observation sheet. Data were analyzed univariately and bivariately by using the chi square test and followed by an alternative fisher's exact test. Obtained variable value ρ value = 0.000 which is smaller than the value of α = 0.05 Then Ho is rejected and Ha is accepted, so there is a relationship between Revised Trauma Score and head injury mortality. So it can be concluded that there is a relationship between Revised Trauma Score (RTS) and head injury mortality. It is suggested that the Hospital is able to improve the application of the Revised Trauma Score (RTS) assessment.

The Incidence and Outcomes of Head Injuries in People with and without Parkinson's Disease.

Fall-related injuries are a major health concern among people with Parkinson's disease (PD). We compared the incidence and post-injury mortality of head injuries and traumatic brain injury (TBI) among persons with and without PD. This register-based study was conducted on the FINPARK cohort which includes 22 189 persons who were diagnosed with PD in Finland 1996-2015. We excluded persons with a previous head injury, leaving 20 514 persons with PD. For each person with PD, 1-7 matching persons without PD and previous head injury were identified with respect to age, sex and residence. The Cox proportional hazard model was used to estimate hazard ratios for head injury. A logistic regression model was used to compare mortality. Persons with PD had 2.16-fold (95% CI 2.06-2.26) risk of all head injuries and 1.97-fold (95% CI 1.84-2.10) risk of TBI after adjustment for age, sex and comorbidities. Persons with PD had a higher one-year mortality after any type of head injury (adjusted odds ratio [aOR] 1.44 95% CI 1.28-1.62), TBI (aOR 1.33 95% CI 1.14-1.57) or non-TBI head injury (aOR 1.72 95% CI 1.42-2.07) than persons without PD. The higher risk of mortality was observed six months after TBI and one month after non-TBI injury in persons with PD. Persons with PD and head injury also had a higher one-year mortality than persons with PD and without head injury. Persons with PD have a higher risk of head injury and a higher post-injury mortality than persons without PD.

Head Injury and Long-term Mortality Risk in Community-Dwelling Adults

Head injury is associated with significant short-term morbidity and mortality. Research regarding the implications of head injury for long-term survival in community-dwelling adults remains limited. To evaluate the association of head injury with long-term all-cause mortality risk among community-dwelling adults, with consideration of head injury frequency and severity. This cohort study included participants with and without head injury in the Atherosclerosis Risk in Communities (ARIC) study, an ongoing prospective cohort study with follow-up from 1987 through 2019 in 4 US communities in Minnesota, Maryland, North Carolina, and Mississippi. Of 15 792 ARIC participants initially enrolled, 1957 were ineligible due to self-reported head injury at baseline; 103 participants not of Black or White race and Black participants at the Minnesota and Maryland field centers were excluded due to race-site aliasing; and an additional 695 participants with missing head injury date or covariate data were excluded, resulting in 13 037 eligible participants. Head injury frequency and severity, as defined via self-report in response to interview questions and via hospital-based International Classification of Diseases diagnostic codes (with head injury severity defined in the subset of head injury cases identified using these codes). Head injury was analyzed as a time-varying exposure. All-cause mortality was ascertained via linkage to the National Death Index. Data were analyzed between August 5, 2021, and October 23, 2022. More than one-half of participants were female (57.7%; 42.3% men), 27.9% were Black (72.1% White), and the median age at baseline was 54 years (IQR, 49-59 years). Median follow-up time was 27.0 years (IQR, 17.6-30.5 years). Head injuries occurred among 2402 participants (18.4%), most of which were classified as mild. The hazard ratio (HR) for all-cause mortality among individuals with head injury was 1.99 (95% CI, 1.88-2.11) compared with those with no head injury, with evidence of a dose-dependent association with head injury frequency (1 head injury: HR, 1.66 [95% CI, 1.56-1.77]; 2 or more head injuries: HR, 2.11 [95% CI, 1.89-2.37]) and severity (mild: HR, 2.16 [95% CI, 2.01-2.31]; moderate, severe, or penetrating: HR, 2.87 [95% CI, 2.55-3.22]). Estimates were similar by sex and race, with attenuated associations among individuals aged 54 years or older at baseline. In this community-based cohort with more than 3 decades of longitudinal follow-up, head injury was associated with decreased long-term survival time in a dose-dependent manner, underscoring the importance of measures aimed at prevention and clinical interventions to reduce morbidity and mortality due to head injury.

Head Injury and All-Cause Mortality in Community-Dwelling Adults (P5-5.005)

Head Injury and All-Cause Mortality in Community-Dwelling Adults (P5-5.005)

A retrospective study to analyze treatment of post traumatic cerebro spinal fluid rhinorrhea and role of trans cranial pedicled pericranial repair in present day context

: Skull base fractures are a major cause of morbidity and mortality in head injury. Anterior cranial Fossa (ACF) skull base fracture, leading to Cerebro Spinal Fluid (CSF) Rhinorrhea is one of the most commonly encountered presentation in ACF base fractures. The key to successful management of such cases lies in early diagnosis and surgical management before it leads to meningitis and avoidable mortality.To evaluate the cases of post traumatic CSF rhinorrhea and analyze the parameters utilized to guide the management strategies. An attempt was made to come up with guidelines for its management in a tertiary care hospital.This was a retrospective study in which all cases of traumatic CSF Rhinorrhea admitted to Tertiary care hospital were included. Patients were divided into three groups. First group was conservatively managed in which the rhinorrhea and serial imaging findings showed favourable response.In thesecond group patients were subjected to endoscopic repair by the ENT surgeon based on anatomical considerations. The third group included patients who were had failed the trial of conservative management and the site of leak did not favor endoscopic repair.The outcomes in all these groups were analyzed and conclusions drawn.A total of 54 patients were included in the study which was conducted between Jan 2014 to 2020. 24 were successfully managed conservatively,10 were managed with endoscopic repair and 20 were managed by bifrontal craniotomy and pedicled pericranial ACF Base repair. There was one case from the first group who developed CSF leak after one month necessitating ACF base repair. There was no recurrence reportedin the cases managed endoscopically, whereas one case subjected to craniotomy had recurrence requiring lumbar drain placement. With each transcranial surgery there was a refinement in the technique further minimizing complications. We have elaborated on the surgical nuances to ensurebetter outcomes. : Pedicledpericranial flap ACF base repair is an elegant approach which requires an understanding of the mechanism of CSF leak from skull base fractures. This procedure can easily be mastered and when performed correctly provides best results for cases where there are multiple ACF defects, those not accessible by endoscope and also in those cases where imaging is not able to localize the exact site of defect leading to CSF rhinorrhea. Anosmia is an in evitable complication of this procedure. However, the trade off between mortality resulting from meningitis versus anosmia makes it a viable and attractive treatment option.

Severity and Predictors of Outcome of Motorcycle-Associated Head Injury: An Experience from a Regional Neurosurgery Centre in Northern Nigeria

Motorcycle-associated head injury is one of the leading causes of disability and deaths, with its main victims being the motorcyclists, passengers, and pedestrians in their young productive age group. This study determines the role of severity and some predictive factors on survival and mortality of motorcycle-associated head injury. This is a cross-sectional study using data of patients managed for motorcycle-associated head injuries between December 2014 and November 2016. The patients' biodata, clinical findings, and management outcomes were analyzed using Statistical Packages for the Social Sciences version20. A total of 184 patients were analyzed, most of whom (81%) were aged ≤40 years and with a male dominance of 6.7:1. Pupillary abnormality was seen in 43.5% of the patients, and severe head injury occurred in 34.2% of the patients. Hemorrhagic contusion was the most common computed tomography (CT) finding (16.3%). Among 20.8% of the patients who died, 63.2% had severe head injury. Motorcycle-associated head injury predominantly occurred among young men who used a motorcycle for commercial purposes. The survival rate was higher among patients who had brain CT scan performed, extra-axial clots, and operative treatment. However, high mortality was seen among patients who could not afford brain CT scan, and who had bilateral pupillary dilatation, CT findings of abnormalities that are not surgically amenable, and severe head injury.

EPIDEMIOLOGY OF HEAD INJURY- LEVEL 1 TAEI CENTRE STUDY

Introduction: Head injury affects over 60 million people every year which causes mortality and morbidity. Of all the injuries, head injury accounts for most cases of death and disability. Sixty-nine million individuals worldwide sufferred from head injury in 2018. As the time progresses there is observable increase in rates of Head injuries. Hence this study focuses on this aspect of injuries in a level 1 TAEI centre. Research studies from TAEI centre are sparse as of now and this study will be a helpful tool for illumination of further research and development which will be useful in reducing public health burden. TAEI (Tamilnadu Accident and Emergency Care Initiative) : Tamilnadu Government have initiated TAEI centres along the National and major State highways. This is in co-ordination with 108 free ambulance service, Government hospitals and CMCHIS schemed private hospitals. It provides immediate and free treatment to the trauma patients. Aim : To study the Epidemiology of Head Injury in level 1 TAEI centre, Coimbatore medical college and hospital, Coimbatore. Materials And Methods: This study is a prospective study covering all head injury cases admitted from November 2020 - January 2021 in level 1 TAEI centre, Coimbatore medical college and hospital, Coimbatore. The treatment is initiated upon arrival in Zero delay ward and they are triaged by TAEI team. These patients are treated according to the protocol of Department of Neurosurgery. This study covers the management, discharge and follow up of these patients. Results: The admitted head injury patients in TAEI ward are 1319 cases out of 1750 trauma cases. Among them RTA tops head injury mortality and morbidity. Among RTA, Two wheeler associated injuries were most common. Drunken drive, not wearing helmets and protective gears played a vital role in head injuries. Conclusion : The primary prevention can be the key to reduce the national burden of head injuries.

EPIDEMIOLOGY OF HEAD INJURY - A LEVEL 1 TAEI CENTRE STUDY

Head injury affects over 60 million people every year which causes mortality and morbidity. Of all the injuries, head injury accounts for most cases of death and disability. Sixty-nine million individuals worldwide suffered from head injury in 2018. As the time progresses there is observable increase in rates of Head injuries. Hence this study focuses on this aspect of injuries in a level 1 TAEI centre. Research studies from TAEI centre are sparse as of now and this study will be a helpful tool for illumination of further research and development which will be useful in reducing public health burden. TAEI ( Tamilnadu Accident and Emergency Care Initiative ) : Tamilnadu Government have initiated TAEI centres along the National and major State highways. This is in co-ordination with 108 free ambulance service, Government hospitals and CMCHIS schemed private hospitals. It provides immediate and free treatment to the trauma patients. Aim : To study the Epidemiology of Head Injury in level 1 TAEI centre, Coimbatore medical college and hospital, Coimbatore. Materials and Methods : This study is a prospective study covering all head injury cases admitted from November 2020 - January 2021 in level 1 TAEI centre, Coimbatore medical college and hospital, Coimbatore. The treatment is initiated upon arrival in Zero delay ward and they are triaged by TAEI team. These patients are treated according to the protocol of Department of Neurosurgery. This study covers the management, discharge and follow up of these patients. Results : The admitted head injury patients in TAEI ward are 1319 cases out of 1750 trauma cases. Among them RTA tops head injury mortality and morbidity. Among RTA, Two wheeler associated injuries weremost common. Drunken drive, not wearing helmets and protective gears played a vital role in head injuries. CONCLUSION : The primary prevention can be the key to reduce the national burden of head injuries.

Tracheostomy Practices for Mechanically Ventilated Patients in Malawi.

BackgroundTracheostomy is used for patients who require prolonged mechanical ventilation. Extensive research has described the provision and optimal timing of tracheostomy, but very little describes tracheostomy utilization in low- and middle-income countries, particularly in sub-Saharan Africa.MethodsThis prospective cohort study describes patients admitted to the intensive care unit (ICU) of a tertiary hospital in Malawi who received tracheostomy versus those who did not, with a primary outcome of hospital mortality. We performed subgroup analysis of patients with severe head injuries.ResultsThe analysis included 451 patients admitted to the study ICU between September 2016 and July 2018. Overall hospital mortality was 40% for patients who received tracheostomy and 63% for patients who did not. Logistic regression modeling revealed an odds ratio (OR) of 0.34 (95% CI 0.18–0.64) for hospital mortality among patients who received tracheostomy versus those who did not (p < 0.001). Standardized mortality ratio weighting revealed an odds ratio of 0.81 (95% CI 0.65–0.99, p < 0.001) for hospital death among patients who received tracheostomy versus those who did not. In the subgroup excluding severe head injury, both ICU (50%) and hospital mortality (75%) were higher overall, but hospital mortality was not more common for patients with tracheostomy versus without (OR 1.28, 95% CI 0.94–1.74, p = 0.104).ConclusionsTracheostomy is not associated with hospital mortality in a Malawi ICU cohort, but these results are affected by the presence of head injury. Research may focus on home tracheostomy care given the lack of hospital discharge options for patients in austere settings.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00268-021-06176-3.

Risk Factors, Pattern and Outcome of Motorcycle-associated Head Injury in Sokoto: An Analysis of 184 Cases

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Materials and Methods This was a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.

The collateral fallout of COVID19 lockdown on patients with head injury from north-west India.

The COVID19 lockdown has altered the dynamics of living. Its collateral fallout on head injury care has not been studied in detail, especially from low- and middle-income countries, possibly overwhelmed more than developed nations. Here, we analyze the effects of COVID19 restrictions on head injury patients in a high-volume Indian referral trauma center. From the prospective trauma registry, clinico-epidemiological and radiological parameters of patients managed during 190days before and 190days during COVID19 phases were studied. As an indicator of care, the inpatient mortality of patients with severe HI was also compared with appropriate statistical analyses. Of the total 3372 patients, there were 83 head injury admissions per week before COVID19 restrictions, which decreased to 33 every week (60% drop) during the lock phases and stabilized at 46 per week during the unlock phases. COVID19 restrictions caused a significant increase in the proportion of patients arriving directly without resuscitation at peripheral centers and later than 6h of injury. Though the most common mechanism was vehicular, a relative increase in the proportion of assaults was noted during COVID19. There was no change in the distribution of mild, moderate, and severe injuries. Despite a decrease in the percentage of patients with systemic illnesses, severe head injury mortality was significantly more during the lock phases than before COVID19 (59% vs. 47%, p= 0.02). COVID19 restrictions have amplified the already delayed admission among patients of head injury from north-west India. The severe head injury mortality was significantly greater during lock phases than before COVID19, highlighting the collateral fallout of lockdown. Pandemic control measures in the future should not ignore the concerns of trauma emergency care.

Outcomes of Surgical Patients Admitted to the Intensive Care Unit of Jimma University Medical Center

Background: Intensive Care Unit is a part of a hospital where critically ill patients that required advanced airways, respiratory or homodynamic support are admitted. However, the patterns of admission and outcome of the critical surgical patients admitted to Intensive Care Unit of Jimma University Medical Center not well understood. Therefore, the aim of this study was to assesspatterns of admission and outcome of surgical patients admitted the intensive care unit of Jimma University Medical Center. Methodology: A cross-sectional retrospective study was conducted in Jimma University Medical Center. Records of surgical patients admitted to intensive care unit from Sept1, 2016-Sept1, 2017 were reviewed. Data abstracted from patient records include diagnosis at admission and outcome of admission. Descriptive statistic, such as frequencies, proportions and means were calculated. Possible association patients’ outcome and predictor variables were determined using Chi- Square Test. Result: Duringone year, 113 surgical patients admitted to intensive care unit of Jimma University Medical Center. Males accounted 61.1% of the admission. Commonest diagnosis at admission was isolated head trauma accounting 36 out of 113 admissions (31.9%). Overall ICU complication rate was 46.9 %. Overall ICU mortality rate was 39.8%. The highest mortality rate was recorded for head injury at 52.8% Conclusion: High complication rate and mortality rate is indicative of poor quality of care in the intensive care unit of Jimma University Medical Center. Head injury mortality rate is particularly higher and need preventive measures.

TEKNIK EVAKUASI CEDERA KEPALA PASCA BENCANA KETEPATAN TEKNIK EVAKUASI PADA KORBAN CEDERA KEPALA DALAM MENGURANGI KEJADIAN CEDERA SEKUNDER

Evacuation is an effort to redeploy the victims from the affected area to a safer region to acquire the rescue. Nowadays the lack of a adequate transfer to evacuate disaster victims are the phenomenom which occur in social case spesifically the health workers who get high potency to increase the occurence of secondary injuries to victims. ratio of the results of health research at 2007 and 2013, point out the enhancement of prevalence of head injury from 7,5% being 8,2% and one of the hospital in Indonesia has held a data which made into a vocal point assert that head injury cases from year to year have increased. The aim of this literature review is to mitigate morbidity and mortality of head injury which go up every year and underpin the health workers to simplify in carry out evacuation to prevent secondary injuries. This literature review was conducted by seeking the electronic databases journal with engage corresponding keywords. The result of the study postulate the victim of injuries particularly post disaster need rapid and appropriate evacuation, assesment and management techniques to rescue suffers live. The treatment carried out when get a head injury is preserve the patients airway, oversee bleeding and preventing shock, immobilizing patient, avert complication and secondary injuries each circumstances which engage in abnormal and dangerous must be given resuscitation. The handling is done alluding to the necessity of ABCDE method by using the START method and mantain stabilization of the cervical technique using the log roll technique.

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.

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.

Assessing the Impact of a New Emergency Triage System on Head Injury Mortality: Tikur Anbessa Specialized Hospital Emergency Department in Addis Ababa, Ethiopia

Introduction:One of the improvements in Ethiopia’s emergency medical system was the introduction of a five-level Emergency Triage System (ETS) in January 2015 that was piloted in selected Addis Ababa hospitals.Aim:To assess the effect of this intervention on the head injury mortality in Tikur Anbessa Specialized Hospital (TASH) Emergency Department (ED).Methods:Data were retrospectively collected from all medical records of head injury patients seen in Adult TASH- ED over two 6 months periods, before and after the new Emergency Triage System implementation: 01/04/2014 – 30/09/2014 versus 01/04/2016 – 30/09/2016. An inclusion criterion was age above 13 for the records that could be retrieved. Exclusion criterion was “patient declared dead on arrival.” Mortality and patterns of head injury were compared pre- and post-intervention. Chi-square was used for the analysis using STATA 14.Results:A total of 522 Head injury patients were analyzed in the ED in both the pre- 258 and post-264 intervention study periods. Among head injury admission in the ED in both study periods, the highest number of patients were Road Traffic Accident/RTA/ victims, males and young age (&lt;30). Mortality rate among head injury patients decreased from a pre-intervention 44 (17.05%) to post-intervention 27 (10.2%) (OR=0.55 9. 5% CI (0.32, 0.95), p=0.02). The median age of death was 45 years in pre- and 40 years in the post-intervention period, with ages ranging from 13 to 85 and 13 to 96 years, respectively. The proportion of deaths from moderate head injury decreased significantly from 14.0% in pre-intervention to 6.3% in the post-intervention period, respectively (p&lt;0.001).Discussion:The Emergency Triage System at TASH-ED has decreased mortality caused by head injury. This could increase life years saved and productivity in a cost-effective and easily achievable way in resource-poor settings.

Profile of Head Injuries: Prehospital Care, Diagnosis, and Severity in an Ethiopian Tertiary Hospital

Consistent data on head injury is lacking especially in the low- and middle-income countries. Our study tries to characterize patients with head injury at the emergency department of one of the few tertiary public hospitals giving neurosurgical care in the country. A retrospective cross-sectional study was performed from May 2015 to October 2015 in one of the neurosurgical teaching hospitals, Black Lion Specialized Hospital. All adult patients with head injury who visited the emergency department during the study period were included. Data on patients' sociodemographic, mechanism of trauma, clinical presentation, imaging findings, and presence of polytrauma were collected by a pretested questionnaire. The source of data was emergency department logbooks and patient charts. A total of 390 patients with head injury who visited the emergency department were included during the study period. There were 335 males (85.9%) and 55 females (14.1%) with the mean age (standard deviation) of 35.4 (15.6) years. Majority of patients came by taxi constituting 149 (38.2%) of all patients, whereas 147 patients (37.7%) used ambulance. Of 147 patients brought by ambulances, 133 (90.4%) were referred from other hospitals. The majority, 26 (45.6%), of patients who came directly to the emergency department used taxis. It is shown that the mode of arrival and origin of arrival are significantly related, P= 0.000. Mortality of severe head injury at the emergency department was 50.8%. Prehospital care coverage was low and ambulances were used mainly for interhospital transfers. Mortality of severe head injury at the emergency department is high and significantly associated with preventable causes like vital sign derangement.