台北市輕度頭部外傷之流行病學及醫療資源使用情形

Background: The so called ”mild” head injury patients occupied most part of emergency department (ED) visits due to head injuries and exhaust a lot of the medical resources. There are so few studies focus on mild head injury in Taiwan. Methods: A retrospective study of 4271 consecutive patients with mild head injury (Glasgow Coma Scale score 13-15) during a period of 2 years. Epidemiological studies of demographic information, type of injury, relevant clinical information, computed tomography (CT) scan data, and the utilization of medical resources are made. Results: 2594 (60.7%) are male. The incidence of head injury increases while the age older than 65 years. Most of the injuries were associated with traffic accidents, followed by falls. The majority of 15-64 years old victims were injuried due to traffic accidents; the youngest (0-14) and oldest (≥65) were due to fall, with 57.2% and 67.3% respectively. The mean ages were 37.2±19.0 and 52.4±26.4 years for traffic accidents and falls respectively. 60.0% of mild head injury patients were transported by means of ambulances. Patients were sent to medical centers have higher percentage of abnormalities and longer hospital stay than those sent to non-medical centers. Poor prognosis and longer stay were observed in the elderly group. There were total 29 deaths in our study, 20 person's age older than 65 years. Conclusion: The costs on mild head injuries are huge. The elderly group presented with the highest percentage of abnormalities on CT scans, more serious intracranial pathology, requiring surgical interventionred as well as poor prognosis. Therefore, older patients need pay more attention and closely observation. There were some victims ”walked to” ED got neurologic deterioration and even more died. We can't overlook the mild head injuries otherwise they will cause unexpected misery.