In a study published today (28 October) in The Lancet which analysed 1989 – 2003 data from the national Trauma Audit and Research Network database, the team compared the death-rates of patients with head injuries with those of other types of emergency patients and assessed the impact of neurosurgical care on these rates.
The results indicated that patients with head injuries were ten times more likely to die, and generally had lower rates of improvement, than those with other types of injuries.
Dr Fiona Lecky of The University of Manchester said: "Mortality rates following head injury have not improved in England and Wales since 1994, and one possible reason is that not all severely head-injured patients are treated in a neurosurgical centres.
"We found that 33% of severely head-injured patients were treated entirely in non-neurosurgical centres, and that this was associated with a 23% increase in mortality. These patients had a 2.29 increase in the odds of death when compared to those treated at neurosurgical centres.
"Changes to NHS emergency-response systems since 1989 have clearly delivered greater benefits to patients without head injuries, and our findings support the Royal College of Surgeons' guidelines which suggest that treatment in a neurosurgical centre is an important strategy in the management of severe head injury. Unfortunately, the current lack of intensive care places in neurosurgical units means that this is often not possible."
The University of Manchester (www.manchester.ac.uk) was formed by the merger of The Victoria University of Manchester and UMIST in October 2004, and with over 36 000 students is the largest higher education institution in the country. Its Faculty of Medical & Human Sciences (www.mhs.manchester.ac.uk) is one of the largest in Europe, with a research income of over £37 million.
The School of Medicine (www.medicine.manchester.ac.uk) is the largest of the Faculty's five Schools, with 1300 staff, almost 2000 undergraduates and a £32M research income. The School is closely linked to five teaching hospitals and a range of general hospitals and community practices across the North West of England.
Journal
The Lancet