2013 年 36 巻 1 号 p. 17-29
There are 3 large studies, Project 1998 (P1998), Project 2004 (P2004) and Project 2009 (P2009), in the Japan Neurotrauma Data Bank (JNTDB). The aim of this report is to clarify the recent status of severe head injury (Glasgow Coma Scale (GCS) score 8 or less on admission) caused by road traffic accident.
The number of severely head-injured patients (age: 6 years or more) injured by road traffic accident were 538 in P1998, 429 in P2004, 325 in P2009. Those were divided into 4 groups according to the modality of accident: 4 wheel vehicle (4WV), motorcycle (MC), bicycle (BC) and pedestrian (P). Analyzed here were age, incidence of alcohol intake, means of patient transportation, GCS, Injury Severity Score (ISS), CT findings (Traumatic Coma Data Bank) and outcome (Glasgow Outcome Scale) at discharge.
Results: In the P2009; 1) The patients were older (median age: 52 years). 2) The incidence of alcohol intake was generally elevated. It was decreased in 4WV and MC groups, but elevated in BC and P groups. 3) The transportation by helicopter was increased in rate. 4) Safety device: The rate is increased as for the seat belt and the air bag, but unchanged in the helmet. 5) The mean ISS was highest among 3 groups. The rate of ISS 70 – 75 was considerably increased. 6) The proportion of diffuse injury type 3 and evacuated mass was decreased in P2004 and this phenomenon continued in P2009. In addition, the rate of diffuse injury type 2 was increased, especially in 4WV and BC groups. 7) The outcome at discharge was worse, especially in P group.
These results might present the recent trend of severe head injury caused by road traffic accident in the JNTDB. But more precise analyses are necessary to understand the data.
