Harding-Goldson H E, Crandon I W, McDonald A H, Augier R, Fearon-Boothe D, Rhoden A, Meeks-Aitken N
Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica, West Indies.
West Indian Med J. 2007 Jun;56(3):230-3. doi: 10.1590/s0043-31442007000300007.
A cross-sectional, descriptive study utilizing data collected in the 'Trauma Registry' of the Department of Surgery, Radiology, Anaesthesia and Intensive Care at the University Hospital of the West Indies (UHWI) was undertaken to document injury severity, surgical requirements and intensive care needs of head-injured patients transferred to the UHWI over a three-year period Of 144 patients studied, the majority (71%) were young males. Overall, injury tended to be mild Twenty-three patients (16.0%) had severe head injury and 27 patients (18.8%) were admitted to the intensive care unit. Concussion with (33%) or without (36%) skull fracture was the commonest neurological admission diagnosis. Associated non-neurological injuries in 33% were primarily fractures. Fifty-six patients (39%) required surgical intervention. Craniotomies and open reduction and internal fixation of fractures were the commonest procedures. The majority of patients (79.2%) were discharged home; 56 (39%) made a good Glasgow outcome score recovery. Seventeen patients (11.8%) died in hospital. As most of the transferred patients with head injuries in this study had only mild injury, most commonly concussions, and their prognosis was good, we recommend that appropriate educational and training programmes and transfer policies be implemented to minimize inappropriate transfers.
利用西印度群岛大学医院（UHWI）外科、放射科、麻醉科和重症监护科“创伤登记处”收集的数据，开展了一项横断面描述性研究，以记录在三年期间转诊至UHWI的头部受伤患者的损伤严重程度、手术需求和重症监护需求。在研究的144例患者中，大多数（71%）为年轻男性。总体而言，损伤往往较轻。23例患者（16.0%）有严重头部损伤，27例患者（18.8%）被收入重症监护病房。伴有（33%）或不伴有（36%）颅骨骨折的脑震荡是最常见的神经科入院诊断。33%的患者伴有非神经科损伤，主要为骨折。56例患者（39%）需要手术干预。开颅手术以及骨折切开复位内固定术是最常见的手术。大多数患者（79.2%）出院回家；56例（39%）格拉斯哥预后评分恢复良好。17例患者（11.8%）在医院死亡。由于本研究中大多数转诊的头部受伤患者仅有轻度损伤，最常见的是脑震荡，且预后良好，我们建议实施适当的教育和培训计划以及转诊政策，以尽量减少不适当的转诊。
