Trend in hospitalization associated with traumatic brain injury

traumatic brain injury
traumatic brain injury surgery performed by Dr. Rajiv Jha's Team

The Changing Trend of Head Injury at two Tertiary Referral Hospitals.

Bir Hospital (the first central government hospital) and National Trauma Centre (the first apex trauma centre, functioning since the Mega earthquake- 2015 AD (Nepal)), receive many trauma patients of which big proportion are head injuries. Over the last 30 years there have been improvements in the provision of care and facilities for the management of head injury patients. It is a high time to evaluate the current trend of head injury and their outcomes.

This is a retrospective study to find the frequency and aetiology of head injury and their final outcome at a tertiary level referral hospital. This study intends to find the changing trends of head injury over time, too. Data on all patients with head injury attending these two hospitals were collected retrospectively for a period of two and a half year. Conscious level was assessed in terms of Glasgow Coma Scale (GCS) and outcomes were measured in Glasgow Outcome Score (GOS).

About 1070 head injury patients were admitted out of 8526 trauma patients who attended the casualty department at National Trauma Center and Bir Hospital. Rests of the patients were discharged or were patients of mild head injury associated with other injuries, for example, extremity fractures, facio-maxillary, abdomen, and chest injury. These patients were admitted by respective departments. Male and female ratio was 2.6:1. Out of the total admitted head injured patients, the highest number of patients (55%) had met a Road Traffic Accident (RTA), followed by fall from height (36%), physical assault (6%) and other cause of head injury (3%) respectively. Surgeries including evacuation of intracranial haematomas were required in 325 cases (30%). Majority (90%) of the patients had favourable outcome at discharge. The number of patients who died during hospital admission was 45, the head injury mortality being 4.2%. 

The mortality of head injury at Bir Hospital and National Trauma Centre is low in this study and seems to be on the decreasing trend over the last 30 years.