Clinical Analysis of Associated Injuries in Head Injuried Patients

ABSTRACT

The increase in the prevalence of head injury amongst civilian population and the provision of adequate hospital services have become matters of world-wide concern. Many present-day accidents may result in the victims receiving multiple complex injuries beside head injuries and the prognosis may become unfavorable in these patients. Therefore, the neurosurgeon must be alert to the possibility that his patients have injuries to areas outside the brain and be capable of rendering necessary, often lifesaving, treatment during the initial phase of management. We analysed associated injuries in 1523 head injured patients admitted to Department of Neurosurgery, Kyung Hee University Hospital from October, 1971 till September, 1977. The results were as follows 1) The incidence of associated injury was 23.6% of all 1523 head injured patients. 2) In all head injuries, male outnumbered female by almost 2 to 1 and the ratio was similar in associated injury group(2.41). 3) The age distribution of all head injuries was 3rd, 1st and 4th decases in order, but in associated injury group it was 4th, 3rd and 5th decades in order. 4) Common causes of head injuries were traffic accidents(76.6%) and fall(11.6%), but in associated injury group traffic accident was the most frequent cause(90.8%). 5) The incidence of associated injury was higher in relation to the severity of head injury. 6) The sites of associated injuries were distributed as limbs, chest and face in order and the most frequent nature of associated injuries was fracture. 7) Single associated injury was more frequent than multiple, associated injury, about 5 to 1. 8) Overall mortality rate of all head injuries was 9.3% in contrast that of associated injuries was 17.5%. 9) Surgical mortality rate was significantly higher in associated group(40.3%) than nonassociated group(26.1%). 10) In multiple associated injuries the mortality rate was higher(21.3%) than in single associated injury(16.4%). 11) Mortality rate according to associated injured sites was as follows ; 36% for visceral injuries and 34.1% for chest injuries. 12) The mortality rate was highest in serious chest injuries such as hemo and/or pneumothorax and in hypovolemic shock on admission(60%).