title: The management of trauma victims with head injury: a study by the National Confidential Enquiry into Patient Outcome and Death.
abstract: BACKGROUND
  In 2006 the National Confidential Enquiry into Patient Outcome and Death undertook a large prospective study of trauma care, which revealed several findings pertaining to the management of head injuries in a sample of 493 patients.
  
  
  METHODS
  Case note data were collected for all trauma patients admitted to all hospitals accepting emergencies in england, wales, Northern Ireland and the Channel Islands over a three-month period. severely injured patients with an injury severity score (iss) of ≥16 were included in the study. the case notes for these patients were peer reviewed by a multidisciplinary group of clinicians, who rated the overall level of care the patient received.
  
  
  RESULTS
  Of the 795 patients who met the inclusion criteria for the study, 493 were admitted with a head injury. Room for improvement in the level of care was found in a substantial number of patients (265/493). Good practice was found to be highest in high volume centres. The overall head injury management was found to be satisfactory in 84% of cases (319/381).
  
  
  CONCLUSIONS
  This study has shown that care for trauma patients with head injury is frequently rated as less than good and suggests potential long-term remedies for the problem, including a reconfiguration of trauma services and better provision of neurocritical care facilities.
authors.affiliation: National Confidential Enquiry into Patient Outcome and Death, UK.
authors.forename: N C E
authors.initials: NC
authors.lastname: Smith
authors.forename: G P
authors.initials: GP
authors.lastname: Findlay
authors.forename: D
authors.initials: D
authors.lastname: Weyman
authors.forename: H
authors.initials: H
authors.lastname: Freeth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000601:surgery*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000458:organization & administration / Q000706:statistics & numerical data; D011364:Professional Practice / Q000592:standards; D011446:Prospective Studies; D012017:Referral and Consultation; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D055815:Young Adult