Grant P T, Shrouder S
Accident and Emergency Department, Western Infirmary, Glasgow.
J Accid Emerg Med. 1997 Jan;14(1):10-2. doi: 10.1136/emj.14.1.10.
To assess the level of missed extracranial injuries in patients transferred to a regional neurosurgical service for ongoing head injury management.
A three year prospective study conducted under the auspices of the Scottish Trauma Audit Group. All patients were followed during their hospital stay by independent audit staff, their injuries being recorded and scored using established criteria.
115 head trauma patients were transferred during the study period. 15 patients died (13% mortality). Eight of a total of 87 separate, scorable extracranial injuries were missed (error rate 9%), none of which was serious. There were no missed injuries in patients who died. 77% of patients were managed by an accident and emergency doctor of at least registrar grade.
In contrast to other published series, this study has shown a low rate of missed extracranial injuries in a group of patients whose initial assessment is notoriously difficult. Early involvement by an experienced accident and emergency doctor may play an important part in the overall management of such patients.
评估转至区域神经外科服务部门进行持续头部损伤管理的患者颅外损伤漏诊情况。
在苏格兰创伤审计小组的支持下进行了一项为期三年的前瞻性研究。所有患者在住院期间由独立审计人员进行跟踪，其损伤情况依据既定标准进行记录和评分。
研究期间共转诊了115例头部创伤患者。15例患者死亡（死亡率13%）。在总共87处可单独计分的颅外损伤中，有8处漏诊（错误率9%），均不严重。死亡患者中无漏诊损伤。77%的患者由至少注册主任级别的急诊医生进行治疗。
与其他已发表的系列研究相比，本研究显示在一组初始评估 notoriously difficult 的患者中，颅外损伤漏诊率较低。经验丰富的急诊医生早期参与可能在这类患者的整体管理中发挥重要作用。
