Kim Eric K, Suri Deepak, Mahajan Anshul, Bhandarkar Prashant, Khajanchi Monty, Gadgil Anita, Ranganathan Kavitha, Gerdin Warnberg Martin, Roy Nobhojit, Raykar Nakul P
University of California San Francisco, School of Medicine, San Francisco, California, USA.
Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.
OTO Open. 2022 Oct 11;6(4):2473974X221128217. doi: 10.1177/2473974X221128217. eCollection 2022 Oct-Dec.
The pattern of head and neck injuries has been well studied in high-income countries, but the data are limited in low- and middle-income countries, which are disproportionately affected by trauma. We examined a prospective multicenter database to describe patterns and outcomes of head and neck injuries in urban India.
Retrospective review of trauma registry.
Four tertiary public hospitals in Mumbai, Delhi, Kolkata.
We identified patients with isolated head and neck injuries using () codes and excluded those with traumatic brain and/or ophthalmic injuries and injuries in other body regions.
Our cohort included 171 patients. Most were males (80.7%) and adults aged 18 to 55 years (60.2%). Falls (36.8%) and road traffic accidents (36.3%) were the 2 predominant mechanisms of injury. Overall, 35.7% required intensive care unit (ICU) admission, and 11.7% died. More than 20% of patients were diagnosed with "unspecified injury of neck." Those with the diagnosis had a higher ICU admission rate (51.4% vs 31.3%, = .025) and mortality rate (27.0% vs 7.5%, = .001) than those without the diagnosis.
Isolated head and neck injuries are not highly prevalent among Indian trauma patients admitted to urban tertiary hospitals but are associated with high mortality. Over a fifth of patients were diagnosed with "unspecified injury of neck," which is associated with more severe clinical outcomes. Exactly what this diagnosis entails and encompasses remains unclear.
高收入国家对头颈部损伤模式已有充分研究,但在中低收入国家,相关数据有限,而这些国家受创伤影响的比例过高。我们研究了一个前瞻性多中心数据库,以描述印度城市地区头颈部损伤的模式和结局。
对创伤登记处进行回顾性审查。
孟买、德里、加尔各答的四家三级公立医院。
我们使用()编码确定了单纯头颈部损伤患者,并排除了有创伤性脑损伤和/或眼损伤以及身体其他部位损伤的患者。
我们的队列包括171名患者。大多数为男性(80.7%),年龄在18至55岁的成年人(60.2%)。跌倒(36.8%)和道路交通事故(36.3%)是两种主要的致伤机制。总体而言,35.7%的患者需要入住重症监护病房(ICU),11.7%的患者死亡。超过20%的患者被诊断为“颈部未明确损伤”。与未诊断出该疾病的患者相比,诊断出该疾病的患者入住ICU的比例更高(51.4%对31.3%,P = 0.025),死亡率也更高(27.0%对7.5%,P = 0.001)。
在入住城市三级医院的印度创伤患者中,单纯头颈部损伤并不十分常见,但与高死亡率相关。超过五分之一的患者被诊断为“颈部未明确损伤”,这与更严重的临床结局相关。该诊断的确切含义和涵盖范围仍不清楚。