Analysis of Cases of Mild Head Trauma Resulting in Fatal Outcome from the Doctor Helicopter Registry Data.

Abstract

Introduction: In cases of mild head trauma, there have been no comprehensive studies on cases that resulted in death. This study aims to conduct a factor analysis of mild head trauma cases resulting in death. Patients with Glasgow Coma Scale (GCS) scores of 14 or 15 in the Japan Doctor Helicopter (DH) Registration System were studied.

Methods: Variables included age, sex, DH request timing, vital signs at DH contact (GCS, blood pressure, heart rate, respiratory rate), head trauma severity, hospitalization, and 1-month outcomes (survival or death). Wilcoxon rank-sum test and median test were used.

Results: Analysis involved 26 deaths and 2256 survivals. No significant differences were found in sex, request timing, pulse rate, systolic blood pressure, or AIS. The death group had higher mean age, respiratory rate and hospitalization rate, and lower GCS scores. Age and respiratory rate cutoffs for mortality were 78 years and 21 breaths/min, respectively. No deaths occurred below 21 breaths/min or at the age of 78 or younger. For those over 79 with 22 or more breaths per minute, 7.8% died.

Conclusions: The study identifies increased mortality risk in elderly patients with mild head trauma, high respiratory rates, and GCS scores of 14 at the scene. This emphasizes the need for careful monitoring and prompt treatment in these cases.