Effect of using a head injury fast-track system on reducing the mortality rate among severe head injury patients in Southern Thailand: A retrospective study with historical control.

CONTEXT: Head injuries are the leading cause of traumatic morbidity and mortality. Timely proper management can reduce the mortality rate.

AIMS: This study aimed to examine the effects of a fast-track system on reducing head injury mortality using the data in Southern Thailand.

SETTINGS AND

DESIGN

A retrospective study of data from the medical records of severe head injury patients admitted to Hatyai Hospital from October 2012 to May 2017.

SUBJECTS AND

METHODS

The records of subjects were selected for participants aged more than 11 years, having Glasgow Coma Score (GCS) <9, no injuries in other organs, and neither hypoxemia nor hypotension. A total of 193 participants fulfilling these criteria were analyzed. Of these, 108 participants were managed in the fast track.

STATISTICAL ANALYSIS USED: The fast-track group was compared with normal track participants by using logistic regression after preliminary analysis to identify the risk factors using the Chi-squared tests.

RESULTS

After adjustment for confounders, namely acute subdural hematoma, linear skull fracture and diffuse brain injury, and mortality in the fast-track group (13%) was significantly lower than that in the nonfast track group (22.4%).

CONCLUSIONS

Using the fast-track system can reduce mortality from severe head injuries and should be implemented in the health services system.