Lewin W, Marshall T F, Roberts A H
Br Med J. 1979 Dec 15;2(6204):1533-8. doi: 10.1136/bmj.2.6204.1533.
From a consecutive series of 7000 patients with head injuries admitted to the regional accident service, Radcliffe Infirmary, Oxford between 10 and 24 years earlier, every patient was taken who had been amnesic or unconscious for one week or longer. Of these 479 patients, all but ten were traced, and either the cause of death was established or the survivors examined. Ten years after injury 4% were totally disabled, and 14% severely disabled to a degree precluding normal occupational or social life. Of the remainder, 49% had recovered, and the rest were dead. Additionally, a selected series of 64 patients whose unconsciousness had been prolonged for a month or more were studied. Forty of these had survived between three and 25 years after injury and were re-examined. On the basis of age at injury, the worst state of neurological responsiveness, and the duration of posttraumatic amnesia, the outcome of head injury can be predicted reliably in most cases. Patients and relatives need more reassurance and simple psychotherapeutic support, especially in the first few months after injury. Extrapolation from our figures suggests that each year in England and Wales 210 patients survive totally disabled and another 1500 are severely disabled.
在10至24年前被收治到牛津拉德克利夫医院地区事故服务中心的连续7000例头部受伤患者中，选取了每一位失忆或昏迷达一周或更长时间的患者。在这479例患者中，除10例之外均被追踪到，要么确定了死因，要么对幸存者进行了检查。受伤10年后，4%的患者完全残疾，14%的患者严重残疾，程度达到无法正常工作或参与社会生活。其余患者中，49%已康复，其余已死亡。此外，还对一组选定的64例昏迷持续一个月或更长时间的患者进行了研究。其中40例在受伤后3至25年存活下来并接受了重新检查。根据受伤时的年龄、神经反应的最差状态以及创伤后失忆的持续时间，在大多数情况下可以可靠地预测头部受伤的结果。患者及其亲属需要更多的安慰和简单的心理治疗支持，尤其是在受伤后的头几个月。根据我们的数据推断，在英格兰和威尔士，每年有210例患者存活但完全残疾，另有1500例严重残疾。
