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J Korean Soc Emerg Med > Volume 7(1); 1996 > Article
Journal of The Korean Society of Emergency Medicine 1996;7(1): 36-43.
Hwa Sik Song, Seok Cheon Hyun, Gab Teog Kim
Department of Emergency medicine, College of medicine, Dankook University, Dankook University Hospital, Chon-an, Korea
  Published online: March 31, 1996.
The author had analyzed respectively a series of 58 patients with severe head injury observed for 6 months from January 1995 to June 1995 to evaluate the significance of the factors affecting outcome. Severe head injury was defined as a Glasgow coma scale(GCS) score of 8 or less after acute non-surgical resuscitation, or deterioration to that level with 48 hours of impact. Our analysis was performed according to the patient's age, initial GCS, pupil change, motor response, CT findings, systolic BP & arterial O2 level. The results were summerized as follows. 1. The most common cause of severe head injury was traffic accidents. 2. The 33(62%) out of 58 patients were found between third decade and sixth decade. 3. The initial GCS had does relationship with pupil change and motor response (P<0.001). Also hypoxia and hypotension affected the initial GCS but then was not significant statistical difference to out-come (P>0.1 ). The pupil change and the motor response were very strongly associated with the initial GCS (P<0.001). Also early hypotension (systolic pressure< ) and early hypoxia (PaO2<60mmHg) had a close correlation with initial GCS, but there was not significant statistical difference to out-come (P>0.1). 4. The factors affecting prognostic difference were initial GCS, pupillary abnormality, abnormal motor response, hypotension and hypoxia.
Key words: Head injury, GCS, Pupil size, Motor response, Hypoxia
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