Epidemiological study of head injuries in central Taiwan

Head injury plays a major role in emergency neurosurgery and is the leading cause of neurosurgical mortality at Taichung Veterans General Hospital. Statistical data show that a similar condition exists in other teaching hospitals in the central Taiwan area, which includes more than one-quarter of the entire population and has more than one-third of the total land of Taiwan. A clinical statistical survey of head injuries in this area may provide a better understanding of the realistic situation in Taiwan. Reports on head injuries in Taipei City, Taipei area, and Hualian County are also cited for comparison.

The present study is based on a cooperative investigation of head injuries by 18 teaching hospitals in central Taiwan from July 1991 to June 1993. All patients received a neurological examination including the Glasgow coma scale (GCS), with recording by 20 Board-certified neurosurgeons.

The 7050 cases collected included 5322 hospitalized cases, 1694 cases seen in the Emergency Room, and 34 deaths on arrival. The leading cause of head injuries was traffic accidents (5354 cases, 76.3%). Motorcycles contributed to the highest number of cases (3661, 68.4%); and trains contributed to the lowest number (8, 0.1%). Helmets were used in only 5.2% of 3503 motorcycle accidents. Based on the patients' or families' description in 4835 cases, the leading cause of the accident was careless driving (1180 cases, 24.4%). The 1088 cases of severe head injury were classified with a score less than 8 by the GCS; 498 of them died, or an 86.6% mortality (575 cases).

Traffic accidents are the leading cause of head injuries, and motorcycles contribute to the major part of it in central Taiwan. Similar conclusions can be drawn for other areas including Taipei City, Taipei area, and Hualian County.