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"Emergency medicine" 8 (55) 2013

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Mortality in Concomitant Craniocerebral Injury

Authors: Poltoratsky V.G. - Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine

Categories: Medicine of emergency

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The combined trauma is an actual problem of modern medicine. According to WHO, in structure of the mortality of the population the trauma takes the third place, and among the population till 40 years — the first. Among all died at a pre-hospital stage, 60–70 % are died of a scull trauma. At very heavy combined traumas with skeletal, thorax, stomach damages with scull trauma the lethality reaches 90–100 %.

Task of our research was to study and analyze a lethality in group died with the concomitant traumatic brain injury in before from 2010 to 2012 in emergency hospital of Kharkov.

There were analyzed histories of diseases 288 died with a combined trauma, which were on treatment in specialized office of a polytrauma of emergency hospital of Kharkov during the period from 2010 to 2012. The office on 55 beds renders the round-the-clock specialized help to patients with a combined trauma. The general surgeons, traumatologists, anaesthesiologist, neurosurgeons enter into the state of office. The office has operational and chambers of intensive therapy which are not included into structure of office of reanimation and intensive therapy of hospital.

From 288 died with a combined trauma the scull trauma of different severity has been revealed at 203 patients that has made 70.49 %. At 154 died there was a heavy scull trauma that has made 75.86 % died with a concomitant traumatic brain injury. The easy scull trauma was at 49 died with a concomitant traumatic brain injury — 24.14 %.

Quantity died (in %) that have arrived in hospital in clear consciousness (15 points by Glasgow Coma Scale (GCS)) were made by 23.6 % of all lethal cases, in devocalization (12–14 points by GCS) arrived 20.2 % died, consciousness violation as a sopor (9–11points by GCS) was noted at 15, 8 % died, in a coma have been delivered 33.5 % died, in 3points by GCS (death of a brain) have been estimated a condition of 6.9 % died.

The greatest number of patients gets a scull trauma, combined with the extracranial damages which have entailed deadly result, as a result of road accidents and falling from height. The number of pedestrians among all participants of road accidents, who have received combenedscull trauma which became a cause of death reaches 79.3 %.

Stably high percent of patients which have died among groups, with cranioskeletal, craniothoracic, and also the highest percent among patients with a craniomultiple trauma is noted. Among patients with a heavy craniomultiple trauma the greatest number died among patients with a cranio-thoracic-abdomino-skeletal trauma and a cranio-thoracic-skeletal trauma.

It is possible to note high percent of lethality among patients of young and middle age who make the most efficient part of the population of the country, thus mortality among men three times exceeds a similar indicator among women.

Especially attracts attention high percent died, traumatized in an alcohol intoxication that, doubtlessly, negatively affects results of treatment of these patients, compared with other victims.

The high percent died, arrived in clear consciousness or in devocalization is connected with weight of an extracranial component and a syndrome of mutual burdening.

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