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CC BY 4.0 · Indian Journal of Neurotrauma 2023; 20(01): 033-036
DOI: 10.1055/s-0042-1759871
Original Article

Practical Challenges in the Management and Outcome of Unknown Patients with Head Injury

Manda Venkata Vijayasekhar
1   Department of Neurosurgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
,
Pathi Rajesh
1   Department of Neurosurgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
,
Kurumella Hema Swaroop
1   Department of Neurosurgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
,
M.P.A. Babu Nagendra
1   Department of Neurosurgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
,
Satyavaraprasad Kadali
1   Department of Neurosurgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
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Abstract

Background Majority of road accidents are treated at nearby private hospitals. Head injury patients whose identity is not established are invariably being treated at government hospitals. The factors influencing the management and outcome of such unknown patients are possible only in government hospitals. Limited studies are available related to these unknown patients.

Objective This study attempted to analyze the management issues in such patients and tried to find solutions that will improve the outcome.

Methods It was an observational study over 2 years. All patients whose identity could not be established at admission were studied. Standard traumatic brain injury protocols were followed. Issues and challenges in managing these patients were noted. Many challenges popped up once patient was shifted out of intensive care unit and were studied.

Results Eighty-five patients were studied with male preponderance. Common age group was 41 to 60 years. The main cause of head injury was road traffic accident. Seventy-six patients were severely injured. Acute subdural hematomas was the most common computed tomography finding (36 patients). Sixty-nine patients were managed conservatively and 16 needed surgery. Forty-nine patients died in hospital, and other patients recovered well. Twenty-two patients were discharged home and 11 took discharge against medical advice after being identified by relatives. None were accommodated into destitute homes even after recovery.

Conclusion Unknown patients usually have poor outcome with more deaths in spite of standard care. Their management is fraught with challenges. They need special care for which staff should be motivated; hospital must have good network to establish identity.

Keywords

unknown patients - destitute patients - traumatic brain injury


Publication History

Article published online:
16 February 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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