Medical complications in severe head injury.

Virtually any medical complication can occur during the post-traumatic course of an individual patient with a severe head injury (SHI). Although recovery of an individual patient can be adversely influenced by any of these medical complications, only a few selected complications have been proven to be independent predictors of an unfavorable outcome. The most frequent medical complications in SHI patients include disturbances of serum electrolytes (60%) and blood coagulation (18%), pneumonia (40%), and septicemia (10%). Hypotension is also common, occurring both prehospital and inhospital at a frequency of 29% and 22%, respectively. These factors are statistically independent predictors of poor outcome in SHI patients. It has been suggested that elimination of these frequent complications might result in a 7.5% reduction of unfavorable outcome in this patient group.