Gorman D F
Arch Emerg Med. 1985 Sep;2(3):121-9. doi: 10.1136/emj.2.3.121.
A prospective study was undertaken of the effects of applying a more selective admission policy to a group of 6685 accident and emergency attenders with head injuries. The efficacy of such a policy was assessed by comparison with 5768 head injury attenders subject to an orthodox admission policy and collected retrospectively. Epidemiological characteristics of both study groups, of patients not admitted but who would previously have been admitted, and of patients admitted because of head injury alone during the prospective study are detailed. The more selective policy was no worse than current practice in terms of immediate morbidity and mortality. Survival of patients with post-traumatic intracranial haematomas was more likely in the prospective group, as was the diagnosis and treatment of such lesions while the patients were alive. Patients admitted because of head injury alone were reduced to one-third of their expected number and all admissions, from among those attenders with head injury in the prospective study, were reduced by half. Adopting such a policy nationally could save 11,000,000 pounds annually.
对6685名头部受伤的急诊患者实施更具选择性的入院政策，进行了一项前瞻性研究。通过与5768名接受传统入院政策的头部受伤患者进行比较，评估了该政策的有效性，后者是回顾性收集的数据。详细介绍了两个研究组、未入院但之前会被入院的患者以及前瞻性研究中仅因头部受伤而入院的患者的流行病学特征。就近期发病率和死亡率而言，更具选择性的政策并不比当前做法差。创伤后颅内血肿患者在前瞻性组中存活的可能性更大，此类病变在患者存活期间的诊断和治疗也是如此。仅因头部受伤而入院的患者减少到预期人数的三分之一，前瞻性研究中头部受伤患者的所有入院人数减少了一半。在全国范围内采用这种政策每年可节省1100万英镑。
