Factors associated with intracranial hemorrhage in mild traumatic brain injury moderated risk patients at Phra Nakhon Si Ayutthaya Hospital

Authors

  • Wasan Limsuriyakan กลุ่มงานเวชศาสตร์ฉุกเฉิน โรงพยาบาลพระนครศรีอยุธยา
  • Pimgarn Lorwanich กลุ่มงานศัลยกรรมระบบประสาท โรงพยาบาลพระนครศรีอยุธยา

Keywords:

Mild head injury, moderate risk, CT brain, Intracranial hemorrhage

Abstract

Backgrounds: Mild head injury patients sent are often for the computed tomography (CT scan) of the head this has led to unnecessary expenses. Moderate and high-risk traumatic head injury patients should be assessed prior head CT scan. There is a study to describe relevant factors to intracranial hemorrhage in mild head injury.

Objective : To study factors associated with presence of intracranial hemorrhage in a mild head injury with moderate risk at Phra Nakhon Si Ayutthaya Hospital.

Material and Methods : This is a retrospective cohort study of 423 patients who was diagnosed as mild head injury with moderate risk at Phra Nakhon Si Ayutthaya Hospital.

Result : Four hundred twenty three patients included in this study, comprise of 26 (6.1%) cases with abnormal brain computed tomography and 397 (93.9%) patients without brain abnormality. They are predominantly male (60.8) %, and 22.7 % had an underlying disease with 29.1% current NSAID used, 29.1% used aspirin and 7.1% used warfarin.The motorcycle accident was the common mechanism (66.9 %). Significant factors associated with the presence of intracranial hemorrhage in mild head injury  patients were 1)  systolic blood pressure 140 - 179 mmHg (adjusted risk ratio (RR) 7.3, 95% confidence interval (CI); 2.1-25.1, p=0.001), 2) systolic blood pressure more than 179 mmHg (RR) 19.2, 95% CI; 6 – 61.1, p<0.001), (3) warfarin usage (RR 1.9, 95% CI; 1.3 – 2.7, p<0.001), 4) suspected base of skull fracture (RR 1.9, 95% CI; 1.2 – 3.2, p=0.011), (5) fall mechanism (RR 2.5, 95% CI; 1.5 – 4.2, p<0.001), and 6) fall from hight (RR 2.4, 95% CI; 1.4 – 3.9, p=0.001).

Conclusion : Factors associated with intracerebral hermorrhage in mild head injury with moderate risk patients were blood pressure more than 140 to more than 179 mmHg, warfarin usage, mechanism of trauma such as fall and fall from hight and patients who have sign of base of skull fracture.

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References

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Published

2019-12-23

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Section

บทความวิจัย