Functional outcome after head injury: comparison of 12-45 year old male and female hormonally active patients.
OBJECTIVE
Head injury is the leading cause of death in patients with major trauma, but little is known of post-trauma rehabilitation morbidity in Hong Kong. The purpose of this study was to identify factors affecting functional outcome in hormonally active patients 6 months after head injury.


METHODS
Secondary analysis of the trauma registry database with data collected prospectively at two trauma centres between January 2001 and December 2007. Demographic and trauma data for patients aged 12-45 years with a head Abbreviated Injury Score ≥3 were analysed. The Glasgow outcome scale (GOS) was used for assessment and was assessed 6 months after head injury. The primary outcome measure was a composite poor outcome, namely "dead, vegetative and severely disabled" measured using the GOS.


RESULTS
Of 698 patients included in the study (mean age 29 years; range 12-45 years; 75.8% male), 581 (83.2%) had a good outcome, and 117 (16.8%) met the primary outcome measure, namely a poor outcome, including 88 (12.6%) patients who died. 453 (64.9%) patients had an injury severity score (ISS) of 16-40, and 102 (14.6%) patients had an ISS>40. 220 (31.5%) patients underwent head injury related operation. The mean length of stay in the intensive care unit (ICU) was 3.9 days. Univariate analysis showed that high ISS, Emergency Department (ED) systolic blood pressure (SBP)>160mmHg or <90mmHg, respiratory rate<12/min or >24/min, low ED Glasgow Coma Score (GCS), trauma call activation, head related operation and ICU admission were related to poor outcome. Multivariate analysis showed that high ISS, low or high ED SBP and low ED GCS were related to poor functional outcome.


CONCLUSIONS
This study showed that ISS, ED SBP and ED GCS were related to poor functional outcome. Gender showed no statistically significant relationship with functional outcome.
Yu
Ada Hoi-yan
AH
Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong. hoiyan@hotmail.com
Cheng
C H
CH
Yeung
J H H
JH
Poon
W S
WS
Ho
Hiu fai
Hf
Chang
A
A
Rainer
Timothy H
TH
D000293:Adolescent; D000328:Adult; D002648:Child; D006259:Craniocerebral Trauma / Q000401:mortality / Q000473:pathology*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult