Outcome in 1,000 head injury hospital admissions: the Athens head trauma registry.
BACKGROUND
The aim of this study was to establish a head trauma registry to (a) examine demographics, etiology, severity, clinical course, and outcome; (b) compare results with previous published series; (c) identify causes of bad outcomes; and (d) propose methods to improve therapy and prognosis.


METHODS
The following data were collected on 1,000 consecutive victims with head injury over 14 years of age admitted during a 4-year period: demographic characteristics, cause of injury, clinical variables, neuroimaging, therapy data, and outcome in 6 months.


RESULTS
Seventy-four percent were men, and mean age was 43 years. Seventy-one percent suffered injuries due to road crashes, 14% due to alcohol, and 2% due to substances. The secondary transfer rate was 49%. For severe injuries, the time intervals from incident to hospital and subsequently to neurosurgical unit were 35 minutes and 4 hours, respectively. In 65% and 72% of cases, there was no record of preresuscitation hypoxia or hypotension, respectively, whereas suspected or definite episodes of hypoxia and hypotension were 27% and 13%, respectively. Most cases were mild trauma (63%), the remaining were severe (26%) and moderate (11%) injuries. Severe systemic trauma coexisted in 18%. Cranial surgery rate was 19% and it increased to 39% in severe trauma. The 6-month overall good outcome was 71%, with lower rates in moderate (58%) and severe (24%) injuries.


CONCLUSIONS
The organization of Greece's first head injury registry offered an important preliminary core data concerning brain trauma etiology, management, and long-term outcome.
Department of Neurosurgery, University of Athens, Evangelismos Hospital, Athens, Greece. stranjal@otenet.gr
George
G
Stranjalis
Triantafyllos
T
Bouras
Stefanos
S
Korfias
Ilias
I
Andrianakis
Marinos
M
Pitaridis
Kiki
K
Tsamandouraki
Yannis
Y
Alamanos
Damianos E
DE
Sakas
Anthony
A
Marmarou
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D006259:Craniocerebral Trauma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D015600:Glasgow Coma Scale; D006115:Greece / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D012042:Registries; D017678:Sex Distribution; D016019:Survival Analysis; D014505:Urban Population