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Journal of The Korean Society of Emergency Medicine 1994;5(2): 240-249. |
| A CLINICAL ANALYSIS ON THE DEATH PATIENTS AFTER HEAD TRAUMA |
| Su Jin Yoo, Jae Hwang Park |
| Department of Emergency Medicine, WonKwang University School of Medicine, Iri, Korea |
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Published online: December 31, 1994. |
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| ABSTRACT |
Study objective ; To compare the difference of the systemic insults between prehospital emergency care and nonprehospital emeregncy care in the death patients after head trauma.
Design ; Retropsective study.
Setting ; The WonKwang university hospital emergency department during 1.1.1993 through 31.6.1994.
Participants ; 101 death patients was admitted after head trauma.
Method
and interventions ; Charts of all death patients after head trauma was reviewed to determine systemic insults between the prehospital emergency care and nonprehospital emergency care. Prehospital emergency care was defined as patients received emergency care from other hospital. Death patients before admission was excluded. Systemic insults were initial laboratory finding at patient's admission.
Measurement ; There were 101 patients admission to neurosurgery after head trauma. All patients were died. The patients were grouped as prehospital emergency care(PHC) and nonprehospital emergency care(NPHC). The most common cause of head trauma was pedestrian traffic accident(53.4%), and sex ratio was 5 : 1. According to clinical features, we found the interval from injury to admission within one hour in 47 cases(46.5%), GCS(3 -7) in 79 cases(78.2% ), RTS (〈5) in 30cases(29.7%),multiple injury in 48 cases(47.5%) and pathologic reflex in 25cases( 24.7% ). According to systemic insults, we found hypotension (〈90mmHg )
in 13 cases(12.9%), acidemia ( 〈7.35) in 55 cases(54.5%), arterial hypoxemia ( 〈60mmHg ) in 25 cases(24.5% ), hypercarbia ( 〉45mmHg ) in 8 cases(7.9% ), anemia( 〈30) in 27 cases(26.8% )
and abnormal LFT in 26 cases(25.8% ). It was no significant statistical result between prehospital emergency care and nonprehospital emergency care. The comparison between systemic insult( + )group and systemic insult( ― ) group were no significant statistical results.
Conclusion
; These results imply that the prehospital emergency care system at the scene of
accident and during the transportation is more important than the simple transportation system in managing the head injury patient.
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| Key words:
Head trauma, Prehospital emergency care, Nonprehospital emergency care, Systemic insults. |
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