Various causes of mortality in patients of head injury: A Nightmare
Introduction: Head injury is an important public health problem today. It is a nightmare, not only for the public but also for the neurosurgeons, because of high morbidity and mortality loss of young people at their productive years. It is also a great financial loss for a family as well as for the country. Unfortunately, incidence of head injury is rapidly increasing in the world, especially in developing countries including India. In India, problem is more acute over last 2 decades, especially due to increased vehicular traffic, poor maintenance of roads and ignorance about traffic rules. In this study we are comparing different causes of mortality in head injury patients.
Materials and Method: The present study design was a prospective cohort consisting of moderately and severely brain injured patients consecutively admitted from August 2014 to February 2017 in surgical emergency wards of M.L.B. Medical College, Jhansi, (U.P). 273 patients with severe and moderate head injury with GCS 3-15 were selected for this study in a random manner.
Results: In this study, 187 patients were male and 86 female, the male: female ratio being 2.17:1. The maximum no. of patients were due to road traffic accidents i.e. 175 (64.1%) followed by those falling from height i.e. 67 (24.54%). Overall mortality was 68.50% in male patients whereas it was 31.50% in females. Maximum number of head injury patients were young adults in the age group of 20-40 years. Patients with low GCS 3-4 have got the highest mortality (51.65%) thus GCS is a good predictor of the outcome of the patients. The morality increases if pupillary reactions are abnormal. Lesser the midline shift better the survival. Multiplicity and presence of bilateral lesion took the prognosis to a graver side.
Conclusion: This study highlights importance of different modes of injury, GCS & CT-Scan findings, age of patients & dominance of male gender in head injuries deaths.
Keywords: Head injury, GCS, CT-Scan, Mortality