The outcome of neuro-trauma. A 1 year retrospective study in an intensive care unit

Introduction

Head injuries are frequent affecting many patients in the prime of life. About 10 million head injuries occur annually in the USA. 20% of these are severe enough to cause brain damage. An initial low GCS 4 has a grave prognosis. Associated injuries may compound the clinical picture. The majority of deaths from head injuries due to raised ICP.

Objectives

To describe our experience with Neuro-Trauma in the ICU.

Design

A retrospective study over 1 year (1999).

Setting

Intensive Care Unit – an academic hospital.

Study population

Patients admitted primarily for the management of head injury.

Results

The total number of admissions was 47, with 37 (87%) males and 10 (21%) females. The mean age of the group was 29.3 ± 14.9 years. Sixteen (34%) patients died. Of the 16, 11 (68.8%) were admitted with a GCS ≤ 4.11 (35.5%) of the survivors had an admission GCS ≤ 4. MVA's accounted for 66% of head injuries, followed by assault injuries at 25.5%. 81.25% of the patients died as a result of the primary brain damage. No association could be established between poor outcome and the presence of concomitant injuries, non-operative management and the number of brain lesions.

Conclusion

Mortality from head trauma is high. An initial low GCS ≤ 4 is associated with poor outcome. A few patients with an initial low GCS do recover fully.