Head injuries in prehospital and Emergency Department settings: a prospective multicenter cross-sectional study in France

期刊论文
出版模式：

开放获取
发表日期：

2024年10月29日

查看全文

Xavier Dubucs,
Thomas Lafon,
Romain Adam,
Solene Loth,
Flore Tabaka,
Florian Negrello,
Mustapha Sebbane,
Valerie Boucher,
Eric Mercier,
Marcel Émond,
Sandrine Charpentier,
Frederic Balen,
Hugo Lenglet,
Hugo Schmit,
Paul Claveries,
Xavier Pereira,
Yann-Erick Claessens,
Jean-Philippe Desclefs,
Delphine Delta,
Aline Lombart,
Hugo Schmit,
Rudy Cohen,
François-Xavier Laborne,
Alicia Gouetta,
Charlène Mourier,
Jonathan Duchenne,
Ayoub Touihar,
Bertrand Boulanger,
Claire Broche,
Tran Duc-Minh,
Maryam Sellami,
Rym Hamed,
Ben Hallouda Kassara,
Emilie Gelin,
Jean Fabre,
Julie Rosenblatt,
Aude-Marie Gangneron,
Chloé Chomarat,
Ombeline Susong,
Lisa Ohayon,
Rachid Gaouiaoui,
Anastasia Dessena,
Bastien Menard,
Adrien Picaud,
Gustave Bangala,
Juliane Bosc,
Romain Blondet,
Didier Darraillans,
Sylvie Grgek,
Davy Murgue,
Fabien Thomas,
Violetta Jauriac,
Anne Chareyron,
Alice Boulanger,
Gwendoline Gonfrere,
Sylvain Thiriez,
Alice Hurgon,
Maud Flambard,
Anna Senon-Laloge,
Tristan Bauduin,
Laurence Berton,
Clotilde Cazenave,
Ernesto Maiello,
Arnaud Bac,
Thomas Bizouard,
Yassine Hicheri,
Matthieu Daniel,
Caleb Faivre,
Bénédicte Clement,
Henri Hani Karam,
Gaëtan Giacomin,
Fabien Coisy,
Jeremy Guenezan,
Pauline Sugranes,
Mélanie Roussel,
Pierrick Le Borgne,
Said Laribi,
Mathieu Abou-Badra,
Aymeric Bodineau,
Alexandre Charney,
Meryl Nguyen Van Tinh,
Hadrien Laporte,
Yahia Yahoui,
Laurent Jacquin,
Richard Chocron,
Gaëlle Le Bail,
Jean Sende,
Thomas Olivier,
Delphine Levy,
Camille Gerlier,
Sarah Addou,
Maxime Gautier,
Eric Burggraff,
Marta Cancella De Abreu,
Pierre Aubertein

摘要

Background

Head injuries are the leading cause of trauma in Emergency Departments (EDs). Recent studies have shown epidemiological changes in patients consulting ED for head injuries. The main objective of this study was to describe the profile of head injury patients consulting in the EDs in France and assess i) head injury severity across age groups; ii) the delay between the occurrence of head injury and ED arrival; iii) factors associated with traumatic intracranial hemorrhage (ICH).

Methods

This cross-sectional study collected patient data over a three-day period in March 2023. All adult patients (≥ 18 years old) admitted to the ED with a head injury (defined as a trauma to the head) were included. TBI severity was classified according to patients’ initial Glasgow Coma Scale score in the ED: severe (3–8); moderate (9 -12); mild (13–15); and simple head trauma in the absence of transient or persistent neurological symptoms.

Results

Among the 71 participating EDs, 26,008 patients visited EDs and a total of 1070 patients (4.1%, IC 95 3.9—4.4) presented a head injury were included in the study, with a median age of 68.5 [37–85] years old. Most of the patients (66.7%) were referred to ED after a call to the Emergency Medical Dispatcher (EMD). The median time from head injury to ED visit was 2 h [1.0 – 5.5]. Ground-level falls were the leading cause of head injury (60.3%). Most of patient presented a simple head trauma (n = 715, 66.8%) followed by mild TBI (n = 337, 31.5%). CT head scans were performed for 636 patients (59.6%), of which 58 were positive. Traumatic ICH prevalence was 5.4% (95% CI: 4.1–6.9) and three patients (0.3%) required an urgent neurosurgical intervention. Neither preinjury anticoagulant (p = 0.97) nor antiplatelet (p = 0.93) use was associated with an increased risk of traumatic ICH.

Conclusions

One head injury patient out of two presenting in the ED is aged over 65 years. Patients referred by EMD were more likely to visit ED promptly. The majority of older patients underwent a head CT scan and preinjury anticoagulant use was not associated with increased risk of traumatic ICH.