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Emergency Medicine Journal 2008;25:670-673; doi:10.1136/emj.2007.053405
© 2008 BMJ Publishing Group Ltd and the College of Emergency Medicine.

ORIGINAL ARTICLES

Factors predicting mortality in victims of blunt trauma brain injury in emergency department settings

K-Y Hsiao1,4, C-T Hsiao1,4, H-H Weng2,4,6, K-H Chen3,4, L-J Lin1,4, Y-M Huang4,5

1 Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
2 Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
3 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
4 College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
5 Department of Nursing, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
6 Graduate Institute of Occupational Safety and Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC

Correspondence to:
Mr Y-M Huang, Department of Emergency Medicine, Chiayi Chang Gung Memorial Hospital, No 6, West Section, Chia-Pu Road, Puzih City, Chiayi County 613, Taiwan, ROC; richard.smith{at}msa.hinet.net

Objective: The aim of the study was to identify risk factors for mortality in patients brought to the emergency department (ED) after blunt traumatic brain injury (TBI).

Methods: The medical records of such patients who visited the ED from June 2004 to May 2005 were retrospectively reviewed. Data (age, gender, initial Glasgow coma scale (GCS) scores, initial vital signs, brain computed tomography scan findings and cause of trauma) were collected from the records of 204 TBI patients, who were treated at the ED and needed intensive care. Among these patients, 48 died in the intensive care unit (ICU) of the hospital. Logistic regression was used to assess factors affecting mortality after trauma.

Results: Age (odds ratio (OR) 1.04; 95% CI 1.01 to ~1.07), GCS score less than 9 (OR 19.29; 95% CI 5.04 to ~73.82) and skull bone fracture (OR 10.44; 95% CI 3.59 to ~30.38) were identified as possible risk factors of mortality in TBI patients.

Conclusion: These predictors appear to be clinically relevant and may help improve ED triage of TBI patients in need of ICU care.


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