Neurosurgery Unit, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK.
Neurosurgery Unit, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK.
World Neurosurg. 2019 Jul;127:e186-e192. doi: 10.1016/j.wneu.2019.03.044. Epub 2019 Mar 14.
Consistent data on head injury is lacking especially in the low- and middle-income countries. Our study tries to characterize patients with head injury at the emergency department of one of the few tertiary public hospitals giving neurosurgical care in the country.
A retrospective cross-sectional study was performed from May 2015 to October 2015 in one of the neurosurgical teaching hospitals, Black Lion Specialized Hospital. All adult patients with head injury who visited the emergency department during the study period were included. Data on patients' sociodemographic, mechanism of trauma, clinical presentation, imaging findings, and presence of polytrauma were collected by a pretested questionnaire. The source of data was emergency department logbooks and patient charts.
A total of 390 patients with head injury who visited the emergency department were included during the study period. There were 335 males (85.9%) and 55 females (14.1%) with the mean age (standard deviation) of 35.4 (15.6) years. Majority of patients came by taxi constituting 149 (38.2%) of all patients, whereas 147 patients (37.7%) used ambulance. Of 147 patients brought by ambulances, 133 (90.4%) were referred from other hospitals. The majority, 26 (45.6%), of patients who came directly to the emergency department used taxis. It is shown that the mode of arrival and origin of arrival are significantly related, P = 0.000. Mortality of severe head injury at the emergency department was 50.8%.
Prehospital care coverage was low and ambulances were used mainly for interhospital transfers. Mortality of severe head injury at the emergency department is high and significantly associated with preventable causes like vital sign derangement.
特别是在中低收入国家，缺乏关于头部损伤的一致数据。我们的研究试图描述在该国为数不多的提供神经外科护理的三级公立医院之一的急诊部的头部损伤患者。
这是一项 2015 年 5 月至 10 月在神经外科教学医院 Black Lion 专科医院进行的回顾性横断面研究。研究期间，所有在急诊就诊的成年头部损伤患者均纳入研究。通过预测试问卷收集患者的社会人口学、创伤机制、临床表现、影像学发现和多发伤情况的数据。数据来源是急诊日志和患者病历。
在研究期间，共有 390 名头部损伤患者到急诊就诊。其中 335 名男性（85.9%）和 55 名女性（14.1%），平均年龄（标准差）为 35.4（15.6）岁。大多数患者是乘坐出租车就诊，共 149 人（38.2%），而 147 人（37.7%）使用救护车。在 147 名乘坐救护车就诊的患者中，有 133 人（90.4%）是从其他医院转来的。而直接到急诊就诊的患者中，26 人（45.6%）是乘坐出租车来的。结果表明，到达方式和来源地之间存在显著关系，P=0.000。急诊重度头部损伤的死亡率为 50.8%。
院前急救覆盖范围较低，救护车主要用于院内转院。急诊重度头部损伤的死亡率较高，与生命体征紊乱等可预防的原因显著相关。
