Correlation between arterial blood gas analysis and outcome in patients with severe head trauma.

BACKGROUND: Traumatic brain injury is one of the major concerns of global public health, because it is the main cause of morbidity and mortality between young people. This study aimed to investigate the possible association between the parameters of arterial blood gas (ABG) and outcome of patients with severe head trauma. METHODS: In this prospective study, 70 patients with severe head trauma were studied in Urmia Imam Khomeini hospital during 18-month period of time. The parameters of ABG were documented within the 1st hour of admission, and their correlation was evaluated with Glasgow coma scale (GCS) and Glasgow outcome score (GOS). These parameters also were compared between expired and discharged patients. RESULTS: Seventy patients with severe head trauma including 60 males (85.7%) and 10 females (14.3%) with a mean age of 34.34±14.82 (range: 18-76) years were studied. The mortality rate during hospitalization was 38.6% (n=27). There was no significant correlation between the parameters of ABG and GCS score and GOS scores. Furthermore, there was no significant difference between the survivors and non-survivors in terms of the mean value of ABG parameters (p>0.05). CONCLUSION: ABG at the time of admission is not a significant predictor of outcome in patients with severe head trauma.

Analysis of orthopedic injuries in an airplane landing disaster and a suggested mechanism of trauma.

Survival after an airplane disaster is rare. We describe the injuries of survivors of an airplane accident and present a common mechanism of trauma for victims. Descriptive data were gathered by interviews with patients, physical examination. Review of charts and patients X-ray films. Informations regarding the flight characteristics were obtained from Iran air safety board. All dead patients were clinically examined by legal medicine department. The suggested mechanism of trauma was established according to present knowledge of mechanism of fractures. From 105 passengers, 27 survived. There was no mortality during hospital course. Between dead passengers, lower extremity fractures were the most common followed by chest wall fractures. Among the survivors, neurosurgical help was needed only in one case for shunt application. Brain concussions and effusions and one hematoma managed conservatively. Two laparotomies were performed for one splenectomy and two hepatoraphy. One pelvic fracture and two femur fractures were occurred. Tibia fractures were the most common (17) followed by spine (14) fractures. Ten tibial fractures were open, and 15 were in distal third. All tibia fractures were fixed with IM locking nails or locking plates. Eight posterior instrumentations were applied for seven burst and two fracture-dislocations. In this landing accident, a combination of vertical loading along with deceleration force produced burst fractures of spine and distal leg fractures.