PMID- 16295557
OWN - NLM
STAT- MEDLINE
DCOM- 20060809
LR  - 20051118
IS  - 0125-1562 (Print)
IS  - 0125-1562 (Linking)
VI  - 36
IP  - 4
DP  - 2005 Jul
TI  - Which mild head injured patients should have follow-up after discharge from an 
      accident and emergency ward? A study in a university hospital setting in 
      Kelantan, Malaysia.
PG  - 982-93
AB  - Mild head injury (MHI) is a common presentation to many hospitals in both rural 
      and urban settings in Southeast Asia, but it is not well studied. We studied 330 
      patients that presented to Hospital Universiti Sains Malaysia Emergency 
      Department with possible MHI, with the intentions to identify prognostic factors 
      that may improve the diagnosis of MHI in the emergency setting as well as to 
      determine which patients would need follow-up. Patients' one-year outcomes were 
      classified as discharged well (DW) for patients without post-traumatic signs and 
      symptoms and discharged with long term follow-up (DFU) for patients with such 
      signs and symptoms. Four patients died and 82 were DFU. An abnormal skull X ray 
      was associated with mode of accident and type of transportation, older age, 
      presence of vomiting, confusion, bleeding from ear, nose or throat, abnormal 
      pupil size on the right side associated with orbital trauma, unequal pupillary 
      reflexes, absence of loss of consciousness (LOC), a lower Glasgow Coma Scale 
      (GCS) score, multiple clinical presentations, and DFU. An abnormal CT scan was 
      associated with older age, multiple clinical presentation, skull X-ray findings, 
      and DFU. A similar analysis on outcomes revealed that mode of accident, older 
      age, vomiting, confusion, headache, bleeding from ear, nose and throat, 
      neurological deficits, absence of LOC, pupil size, multiple presentation, 
      abnormal skull X ray, CT scan of the brain, and a GCS of 13 was associated with 
      DFU. In conclusion, all patients involved in motor vehicle accidents (MVAs), 
      especially motorcycles, aged over 30 years of age, with multiple clinical 
      presentations, including a lower GCS, and with abnormal radiological findings 
      should have a longer follow-up due to persistent post-traumatic symptomatology.
FAU - Chan, H C
AU  - Chan HC
AD  - Department of Accident and Emergency, School of Medical Sciences, Universiti 
      Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
FAU - Adnan, W A W
AU  - Adnan WA
FAU - Jaalam, K
AU  - Jaalam K
FAU - Abdullah, M R
AU  - Abdullah MR
FAU - Abdullah, J
AU  - Abdullah J
LA  - eng
PT  - Journal Article
PL  - Thailand
TA  - Southeast Asian J Trop Med Public Health
JT  - The Southeast Asian journal of tropical medicine and public health
JID - 0266303
SB  - IM
MH  - Accidents, Traffic/*statistics & numerical data
MH  - Adolescent
MH  - Adult
MH  - *Aftercare
MH  - Aged
MH  - Aged, 80 and over
MH  - Child
MH  - Clinical Protocols/standards
MH  - Craniocerebral Trauma/*diagnosis/*therapy
MH  - Emergency Service, Hospital/*standards/*statistics & numerical data
MH  - *Emergency Treatment
MH  - Female
MH  - Glasgow Coma Scale
MH  - *Hospitals, University
MH  - Humans
MH  - Malaysia
MH  - Male
MH  - Middle Aged
MH  - *Patient Discharge
MH  - Prognosis
MH  - Risk Factors
EDAT- 2005/11/22 09:00
MHDA- 2006/08/10 09:00
CRDT- 2005/11/22 09:00
PHST- 2005/11/22 09:00 [pubmed]
PHST- 2006/08/10 09:00 [medline]
PHST- 2005/11/22 09:00 [entrez]
PST - ppublish
SO  - Southeast Asian J Trop Med Public Health. 2005 Jul;36(4):982-93.