2009 Volume 31 Issue 2 Pages 85-90
Emergency medical care of trauma victims has undergone major changes in the last 10 years. The aim of this study was to assess how the improved care influences early physiological abnormalities, intracranial pathology, and outcomes after traumatic brain injury (TBI). Two cohorts of severe TBI patients were compared. The first cohort was treated from 1998 to 2001 and the second from 2004 to 2006. Between groups, the mean age increased from 49±24 years to 53±23 years. The incidences of initial hypoxia and hypotension, which adversely affected outcomes, were decreased. Intracranial mass lesion was more frequent in the second cohort, probably because of the increasing age. The mortality rate was improved, although the proportion of patients with severe disability or vegetative state in survivors was increased. The sustained efforts to reduce early respiratory and circulatory abnormalities during prehospital care probably contributed to this improved mortality rate, but they do not appear to have led to improvements in functional outcomes.