The Influence of Craniotrauma on the Outcome of Polytrauma 1 2

Abstract

Background: Polytrauma is often associated with poor outcome. This is frequently attributed to head injury which is present in a high proportion of such patients. This study examines the influence of head injury on the outcome of polytrauma in a tertiary health institution in Nigeria.
Methodology: A prospective design in which consecutive patients presenting with polytrauma were recruited. They were categorised into those with head injury (A) and those without head injury (B). Out of group A, those in whom head injury was severe (GCS 3 - 8) was extracted and studied ( A1). Data were entered into a proforma and the Epi info 3.2.1 software was used for the statistical analysis. Specifically, the injury severity score, length of hospital stay, morbidity and mortality were compared in the groups.
Results: One hundred and twenty eight patients with polytrauma were studied. There was head injury in 90 patients (A) and no head injury in 38 (B). Of the head injured patients, 13 had severe head injury (A1). There were no statistically significant differences in injury severity score (p=0.7), length of hospital stay (p=0.8), morbidity (p=0.5) or mortality (p=0.48) between the head injured (A) and the non-head injured (B) groups. Severe head injury (A1) was however associated with statistically significant increase in injury severity score (p<0.001), length of hospital stay (p=0.01) and mortality (p=0.006).

Conclusion: It is not all polytraumatised patients with head injury that have an adverse outcome but the subset with severe head injury that do. Laid down protocols for neurosurgical referrals and transfers in patients with severe head injury will benefit this category of patients as they do show adverse outcome in polytrauma.