THE RISK OF INTRACRANIAL HEMORRHAGE IN MILD TRAUMATIC BRAIN INJURY PATIENTS WHO REVISIT THE ACCIDENT AND EMERGENCY DEPARTMENT, NAKHON PHANOM HOSPITAL
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Abstract
Background Head injury is the leading cause of death in all types of accidents. There is mild traumatic brain injury (mTBI) in 81% and they are often not considered not considered to be at risk of a brain concussion. This study aimed to examine the risk profile of mild traumatic brain injury rrepeatedly patients for treatment and presented with cerebral hemorrhage
Method This is an etiognostic research retrospective case control (time matched) at accident and emergency department, Nakhon Phanom hospital. Case is mild head injury (Glasgow Coma Scale, GSC 13-15) patients who returned to treatment (revisit) and found cerebral hemorrhage and control group is mild head injury patients who were discharged, during October 2016 - September 2020.Retrieving information from medical records and hospital's electronic database, the case study group was revisit mild traumatic brain injury patients found that there were 16 cerebral hemorrhages and a time-matched control group was selected before and after 5 cases of each 160 case. General characteristics were analyzed by t-test and exact probability test. Associated risk characteristics of cerebral hemorrhage in patients with mild head injury revisit was analyzed using multivariable logistic regression.
Result There were 16 patients with mild head injury revisit, 8 (50%) of age> 60, had more than 2 underlying diseases (12.5%), High blood pressure > 140 mmHg at arrival 4 (2%), Loss of consciousness 4 (2%), no head wounds, 6 (37.5%), and 6 cases of moderate risk of alcohol or drug use (37.5%).Risk characteristics of cerebral hemorrhage in patients with mild head injury were older than 60 years (OR = 7.00, 95% CI, 2.36 - 20.74) and had a history of alcohol or drug use (OR = 5.4, 95% CI, 1.73 - 16.82) were statistically significant.
Conclusion The risk of cerebral hemorrhage in revisit mild head injury patients is over 60 years of age and has a history of alcohol or drug use. In patients with such characteristics, there should be guidelines for treatment and strictly control the practice to prevent the occurrence of bleeding in the brain.
Keywords: Mild traumatic brain injury, revisit, Intracranial hemorrhage
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