Management and outcomes of patients with brain trauma in a tertiary referral trauma hospital without neurosurgeons on site

Waikato Hospital is a tertiary hospital of over 700 beds receiving large numbers of trauma patients, but has no neurosurgeon closer than 130 kilometres. Over the 10 years ending July 1997, 831 cases of brain trauma were admitted to the Intensive Care Unit. Of these, 191 died before leaving hospital...

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Bibliographic Details
Published in:Anaesthesia and intensive care 1998-12, Vol.26 (6), p.642-647
Main Authors: HAVILL, J. H, SLEIGH, J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Brain Injuries - mortality
Brain Injuries - surgery
Brain Injuries - therapy
Child
Emergency and intensive care: techniques, logistics
Glasgow Coma Scale
Humans
Injury Severity Score
Intensive care medicine
Intensive care unit. Emergency transport systems. Emergency, hospital ward
Medical sciences
Medical Staff, Hospital
Middle Aged
Neurosurgery
New Zealand
Patient Transfer
Survival Rate
Trauma Centers
Treatment Outcome
Workforce
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Summary:Waikato Hospital is a tertiary hospital of over 700 beds receiving large numbers of trauma patients, but has no neurosurgeon closer than 130 kilometres. Over the 10 years ending July 1997, 831 cases of brain trauma were admitted to the Intensive Care Unit. Of these, 191 died before leaving hospital (overall mortality 23%). Of the 547 who had a Glasgow Coma Score (GCS) < or = 8, 173 died (mortality 32%). Of the children who were < 15 years of age and had a GCS < or = 8, there was a 23% mortality. These mortality rates are acceptable when compared with other reports (average 37%, over 12 adult series). Using brain AIS scores, our mortality figures also compared favorably with those in the literature, and suggest that the quality of brain trauma care is adequate in this non-neurosurgical centre with intensive care, backed by CT scanning and general surgeons able to do urgent burr holes. Six percent of the brain trauma patients (approximately five per year), required interhospital transfer for definitive neurosurgical care.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057x9802600605