Odebode T O
Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.
Niger J Clin Pract. 2008 Sep;11(3):265-9.
Most studies of patients with head injury managed outside of indigenous Africa have shown poorer outcome with increasing age, but data on this subject is scanty in this part of the world.
To determine age related pattern and outcome of head injury in an indigenous African setting.
A retrospective analysis of clinical characteristics, mechanism of head injury, associated injury, trauma scores and outcome in patients admitted for head injury at the University Teaching Hospital, Ilorin, Nigeria, between 1989 and 1999.
The 648 patients comprised of 39 older subjects (= 60 yrs), 357 adults (17-59 yrs) and 252 children (= 16 yrs). They were aged 1 to 105 years (mean = 37years). Road traffic injury was the commonest cause of trauma to the head. Children were most often injured as pedestrians while adults and older patients were more often victims of passenger vehicular accidents. Older patients had the poorest outcome with a mortality rate of 48.7%. They were more prone to severe head injury (41.0%) and multi-system trauma (51.3%), with higher mean injury severity scores and lower probability of survival than younger patients. Outcome was predictable by age and GCS (p = 0.0206 & 0.0000) in all age groups put together and in children while GCS was a predictor in adults (p = 0.0000), and none of the variables could predict outcome in the older patients.
The study reaffirms that outcome of head injury worsens with advancing age and indicates that severity of head injury and higher frequency of multi-system trauma may contribute to worse outcome in older patients.
大多数针对非洲以外地区头部受伤患者的研究表明，随着年龄增长，预后较差，但在世界这一地区，关于这一主题的数据很少。
确定非洲本土环境下头部受伤与年龄相关的模式及预后。
对1989年至1999年间在尼日利亚伊洛林大学教学医院因头部受伤入院的患者的临床特征、头部受伤机制、相关损伤、创伤评分及预后进行回顾性分析。
648例患者包括39例老年患者（≥60岁）、357例成年人（17 - 59岁）和252例儿童（≤16岁）。他们的年龄在1至105岁之间（平均37岁）。道路交通伤是头部创伤最常见的原因。儿童最常作为行人受伤，而成年人及老年患者更多是乘用车事故的受害者。老年患者预后最差，死亡率为48.7%。他们更容易发生重度头部损伤（41.0%）和多系统创伤（51.3%），与年轻患者相比，其平均损伤严重程度评分更高，生存概率更低。在所有年龄组及儿童中，年龄和格拉斯哥昏迷评分（GCS）可预测预后（p = 0.0206及0.0000），在成年人中GCS是预后的预测指标（p = 0.0000），而没有任何变量能预测老年患者的预后。
该研究再次证实，头部受伤的预后随年龄增长而恶化，并表明头部损伤的严重程度和多系统创伤的较高发生率可能导致老年患者预后更差。
