Prevention of death from head injury in Natal.
A detailed review of 100 consecutive head injury deaths in the Natal area was undertaken after forensic autopsies had been performed; neurohistological examination was carried out in 69 cases. It was found that one-third of deaths could have been prevented by medical treatment. Hypoxic and ischaemic brain damage was judged to be a contributing cause of death in 88% of all victims. Factors isolated as major causes of preventable death included: failure to prevent hypoxic brain damage by timeous endotracheal intubation and rapid resuscitation; major delays in referral from feeder hospitals; and failure to detect intracerebral haematomas and contusions which subsequently caused raised intracranial pressure. Recommendations for improving this situation are discussed, with particular reference to the situation in Natal.
Bullock
M R
MR
Department of Neurosurgery, University of Natal, Durban.
du Trevou
M D
MD
van Dellen
J R
JR
Nel
J P
JP
McKeown
C P
CP
D000328:Adult; D002423:Cause of Death; D006259:Craniocerebral Trauma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D013019:South Africa; D014187:Transportation of Patients