KUMJ | VOL. 9 | NO. 4 | ISSUE 36 | OCT-DEC, 2011

Outcome of Head Injury Patients Undergoing Surgical Management: A Tertiary Level Experience
Shrestha A, Joshi R M, Thapa A, Devkota UP, Gongal DN

Background

Head injury is the major cause of death in a neurosurgical patient.

Objective

To find the outcome, and treatment modality affecting the outcome in patients with

head injury.

Methods

Nine hundred eighty seven patients presenting to National Institute of Neurological

and Allied Sciences, Kathmandu, with head injury from September 2009 to

October 2010 were included in the study. Patients were categorized according to

post resuscitation Glasgow Coma Score. Outcome was assessed at discharge using

Glasgow Outcome Score and analyzed for any correlation with modality of treatment

and severity of injury.

Results

Among 987 patients with head injury,152 (15.4%) had severe, 126 (12.8%) had

moderate and 709 (71.8%) had mild head injuries. Three hundred twelve (31.6%)

patients required definitive and supportive surgical intervention. One hundred

eighty two required cranial surgical intervention. Overall mortality was 10% (99), 137

patients (13.9%) had unfavorable outcome and 850 (86.1%) had favorable Glasgow

Outcome Score of 4 and 5. Mortality was 53.2%, 9.5% and 0.8% in severe, moderate

and mild head injury group respectively. Mortality rate was significantly higher

(64.6%) in severe head injury group managed conservatively than those in same

group treated with supportive and definite surgical intervention (44.8%) (p=0.016).

Conclusion

Mortality in head injury patients depend upon severity of injury. Mortality in severe

head injury group can be reduced by supportive and definite surgical intervention.