title: Outcome in 2068 patients of head injury: Experience at a level 1 trauma centre in India.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is one of the leading causes of death. Evidence-based guidelines for TBI care have been widely discussed, but in-hospital treatment and outcome of these patients has been highly variable especially in developing countries like India.
  
  
  OBJECTIVE
  To evaluate the epidemiology and outcome of patients with head injuries at a Level 1 trauma center in India.
  
  
  METHODS
  In this retro-prospective study, all patients with head injury who were admitted in the department of neurosurgery over a 15 months period (November 2007-January 2009) were included in the study. Post-resuscitation GCS was used for categorizing the severity of head injuries and outcome was assessed at discharge using GOS. All patients were managed as per laid down departmental protocols.
  
  
  RESULTS
  A total of 2068 patients of head injury were admitted during the study period. The mean age was 24 years (range 1-85). 71.4% were male and 28.6% were female. The most commonly involved age group was 20-40 years (43%) and the most common mode of injury was road traffic accidents (64%). 53% of the patients had severe head injury (GCS ≤ 8), 18% had moderate head injury (GCS 9 ≤ 13) and 29% had minor head injuries (GCS ≥ 14). The mean hospital stay was 14 days (range 1-62 days). Overall in-hospital mortality was 22% (454 cases). 39% died within 48 hours of injury. 2% of minor, 12% of moderate and 36% of severe head injured patients expired; Mortality was 38% in children (≤12 years). Amongst those who survived, 45% had good outcome (GOS 4 or 5), 13% were severely disabled (GOS 3) and 19% were vegetative (GOS 2).
  
  
  CONCLUSIONS
  This is the one of the largest single center study on severe head injuries and shows enormity of the problem facing developing countries like India.
authors.affiliation: Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Agrawal
authors.affiliation: Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.affiliation: Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: D
authors.initials: D
authors.lastname: Gupta
authors.affiliation: Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Sinha
authors.affiliation: Department of Neurosurgery, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: G D
authors.initials: GD
authors.lastname: Satyarthee
keywords: Developing country; head injury; management; mortality; outcome