An audit of head trauma care and mortality
General Surgery; Neurosurgery
OBJECTIVE: To analyze the factors contributing to deaths from head trauma by using standardized assessment parameters and to provide a peer-review of head injury deaths with focus on identifying deficiencies and analyzing contributory factors.
DESIGN: Descriptive study.
PLACE AND DURATION OF STUDY: The study was carried out at the Emergency, Aga Khan University Hospital during January 1998 to December 1999.
SUBJECTS AND METHOD: One hundred and three patients above the age of 15 years presenting alive to the Aga Khan University Hospital (AKUH) emergency with head injury were included in this study. Identified deaths data was reviewed by the Hospital Trauma Peer Review Committee and consensus arrived at for categorization of deaths. The potential deficiencies in care were identified and final recommendations made. The data was computed on CDC Trauma Registry (V 3.0) and SPSS (V 8.0).
RESULTS: Mean age was 31.9 years (n=103) with predominant male population (4:1). Severe head injury (GCS)
CONCLUSION: Transfer of inappropriately managed patients, lapses in inter-hospital communications, delayed transfers were identified as the major pre-hospital factors whereas lack of ICU beds, portable ventilators in emergency room, delays in CT scan facilities were the deficiencies in the hospital services. Opportunities for improvement in head trauma care are needed to focus on initial resuscitation and appropriate surgical management.
Journal of College of Physicians and Surgeons Pakistan
(2004). An audit of head trauma care and mortality. Journal of College of Physicians and Surgeons Pakistan, 14(3), 173-177.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_surg_neurosurg/95