Abstract
This study was conducted to clarify the recent trends of severe head injury in the Japan Neurotrauma Data Bank (JNTDB) with special reference to traffic accident.
In the JNTDB, the number of severely head-injured patients (Glasgow Coma Scale (GCS) score of 8 or less) were 832 in Project 1998 and 797 in Project 2004. Those were divided into 2 groups: traffic accident (TA) group, and non-TA (nTA) group. In addition, the former group was classified into 4 groups: 4 wheel vehicle (4WV) group, motorcycle (MC) group, bicycle (BC) group, and pedestrian (P) group. Analyzed here were cause of injury, age distribution, incidence of alcohol intake, means of transportation, clinical severity (GCS and injury severity score), initial CT findings (Traumatic Coma Data Bank), and outcome at discharge (Glasgow Outcome Scale).
Results: In the Project 2004; 1) Traffic accident was less common as the cause of injury. 2) The proportion of younger patients was lower in the TA group, especially in the 4WV and MC groups. 3) Incidence of alcohol intake was lower in the TA group, particularly in the MC groups. 4) Patient transfer by helicopter was more common in both the TA and nTA groups. 5) The proportion of GCS of 3 to 5 was lower in the TA group, especially in the MC group. 6) In the initial CT findings, type 3 of diffuse injury and evacuated mass were less frequent in both groups, and in the 4WV, BC, and P groups. 7) Outcome at discharge: Mortality rate was lower in both groups, and in the 4WV, MC and P groups, but the percentage of good outcomes was unchanged.
These results indicated the recent trends of severely head-injured patients who were injured by traffic accident. But there were some problems, such as study protocol and meaningless results, so that further verification is indispensable in the JNTDB study.
