[Management of patients with severe head injury in Hungary, in 2002]

In Hungary, epidemiological and clinical data regarding brain injury were rather scarce. The Hungarian Society for Neurotrauma aimed to make a nation-wide study about the number and the mortality of patients with severe head trauma, the organization of management, the diagnostics and monitoring in use, and finally about the clinical practice of management. A national survey was carried out with questionnaires asking about data of 2001, and a prospective, three-month-long data collection based on case studies was also executed in 2002. The Hungarian National Ambulance and Emergency Service centralized information gathering on rescue, and transportation. To collect data of hospital care, a network of regional coordinators and hospital communicators was developed. The responders covered 76% of the hospital neurotrauma care in the country. The number of brain trauma patients was close to 14,000 per year: 71.3% mild, 19.4% moderate, and 9.4% severe trauma. According to prospective study the mortality of those patients who were admitted as severe head injury patients was 55% and the mortality of those who got into severe condition later was 35% during the acute care. These data showed much worse outcome than those published in Western European countries and North America. In the background the authors found communication disorder between prehospital and hospital care, extreme long time spent until the patients got to the first CT-exam and to the definitive care. The implementation of Hungarian and international head trauma guidelines did not spread widely.