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Head injuries in accident and emergency departments. How different are children from adults?
M Brookes1, R MacMillan, S Cully
1Department of Accident and Emergency Medicine, Monklands District General Hospital, Airdrie, United Kingdom.
Insights
Children and adults with head injuries show different patterns of brain damage and hospital admission. These findings offer crucial insights for improving emergency department services for head-injured patients.
Area of Science:
- Emergency medicine
- Pediatric neurology
- Trauma care
Background:
- Head injuries are a common reason for emergency department visits.
- Understanding age-specific injury patterns is crucial for effective resource allocation.
Purpose of the Study:
- To compare head injury presentations in children versus adults at accident and emergency departments.
- To establish population-based estimates for head injury frequencies by age group.
Main Methods:
- Retrospective analysis of case records from 23 Scottish accident and emergency departments (1985).
- Comparison with prospective data from one hospital (1984).
- Analysis of 3838 children and 4775 adults with head injuries.
Main Results:
- Brain damage was less frequent in children (9%) than adults (20%).
- Scalp lacerations occurred in approximately 40% of both groups.
- Children had lower admission rates (11%) compared to adults (20%).
Conclusions:
- This study provides the first population-based data on head injury frequency in children and adults.
- Findings are valuable for planning services for head-injured individuals.
- Age-specific data can inform targeted interventions and resource allocation.
Study Objective:
The aim of the study was to examine the differences between child and adult patients attending accident and emergency departments after recent head injuries.
Design And Setting:
A retrospective survey based on existing case records from 23 Scottish accident and emergency departments for 1985 was compared with prospective data from one hospital over 9 months in 1984.
Patients:
3838 children under 15 and 4775 adults attended hospital with head injuries during the period analysed.
Main Results:
Only 9% of children and 20% of adults had evidence of brain damage (altered consciousness on arrival, or history of altered consciousness with amnesia on arrival). Scalp lacerations were recorded in approximately 40% of both children and adults, more commonly in those without brain damage. Fewer children than adults had a skull x ray; in both age groups x rays were more often done if there was evidence of brain damage, headache, or vomiting, and less often when there was a scalp laceration. Only 11% of children were admitted compared with 20% of adults. Admission rates per 100,000 population per year were 4011 for children and 1473 for adults (1967 overall); admission rates for brain damage were 290 for children and 341 for adults (331 overall).
Conclusions:
These are the first population based estimates of frequency of head injuries presenting at accident and emergency departments, analysed by age, gender and cause of injury. They should be of value when planning services for the head injured.