title: Missed injury in patients with severe traumatic brain injury complicated by multiple trauma.
abstract: OBJECTIVE
  The aim of this study was to investigate retrospectively the multiple injuries prone to be missed in 432 cases.
  
  
  METHODS
  The cases were divided into two groups, i.e., whether the missed injury was found during admission or follow up. The mean ISS value, ratio of patients of cases with GCS < 8, and mortality were calculated and compared. The incidences of missed diagnosis of various body parts were calculated and compared with one another to identify the multiple injuries prone to be missed during the diagnosis for severe traumatic brain injury patients accompanied by multiple trauma.
  
  
  RESULTS
  Among the 432 patients, 54 patients had missed injuries. The mean ISS value and the ratio of patients of cases GCS < 8 in the missed group were higher compared with those in the non-missed group. The missed diagnosis ratio of various body parts had significant differences. Injuries in the optic nerve and abdomen were the more often missed injuries in the diagnosis.
  
  
  CONCLUSIONS
  The multiple trauma severity and coma degree impact diagnoses for severe TBI complicated by multiple injuries is highly accurate. The early diagnosis of injury is of the highest importance so that the injury may be treated immediately.
authors.affiliation: 101th Military Hospital of PRC, Army's Traumatic Brain Injury Center, Wuxi, P.R. China.
authors.forename: Feng
authors.initials: F
authors.lastname: Yi
authors.forename: Shi
authors.initials: S
authors.lastname: Zhonghua
authors.forename: Wang
authors.initials: W
authors.lastname: Yuhai
authors.forename: Dong
authors.initials: D
authors.lastname: Jirong
authors.forename: Cai
authors.initials: C
authors.lastname: Xuejian
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D003951:Diagnostic Errors; D015600:Glasgow Coma Scale; D006801:Humans; D009104:Multiple Trauma / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D020221:Optic Nerve Injuries / Q000175:diagnosis; D012189:Retrospective Studies