Mendelow A D, Teasdale G, Jennett B, Bryden J, Hessett C, Murray G
Br Med J (Clin Res Ed). 1983 Oct 22;287(6400):1173-6. doi: 10.1136/bmj.287.6400.1173.
A study was conducted to estimate the risk that an adult (age 15 or over) will develop a surgically significant intracranial haematoma after a head injury. Two simple features were used that can be recognised by clinicians with minimal training: a skull fracture and the conscious level. The risks were calculated from samples of 545 patients with haematomas, 2773 head injured patients in accident and emergency departments, and 2783 head injured patients in primary surgical wards. With radiological evidence of skull fracture and any impairment of consciousness (including disorientation) one patient in four in an accident and emergency department or primary surgical ward will develop a haematoma. With no skull fracture and preserved orientation the risk to a patient in an accident and emergency department is one in 6000. The use of risk levels as a basis for decision making about head injured patients may result in fewer haematomas being detected too late and savings of resources by reducing the admission and investigation of low risk categories of patients.
一项研究旨在评估成年人（15岁及以上）头部受伤后发生具有手术指征的颅内血肿的风险。研究使用了两个简单的特征，经过最少培训的临床医生即可识别：颅骨骨折和意识水平。风险是根据545例血肿患者、2773例事故和急诊科头部受伤患者以及2783例初级外科病房头部受伤患者的样本计算得出的。有颅骨骨折的放射学证据且有意识障碍（包括定向障碍）的情况下，事故和急诊科或初级外科病房中每四名患者中有一名会发生血肿。没有颅骨骨折且定向正常的情况下，事故和急诊科患者发生血肿的风险为六千分之一。将风险水平作为头部受伤患者决策的依据，可能会减少因发现血肿过晚而导致的情况，并通过减少低风险患者的入院和检查来节省资源。
