Comparison of two surveys of head injured patients presenting during a calendar year to an urban medical centre 32 years apart.

OBJECTIVE To study the patients presenting with head injuries to a tertiary hospital in Karachi during the year 2003. METHODS During the calendar year 2003, a cross-sectional study was conducted of all patients presenting to the casualty department of Jinnah Postgraduate Medical Centre (JPMC) with head injury. Personal information was collected from the patient's attendants at presentation or later if the patient had been brought in by the emergency services as an unknown person. The circumstances of the injury were similarly established and the clinical features documented. RESULTS During the year 2003, a total of 3008 patients reported to the emergency room of JPMC. Of these 67% were males and the majority of the reporting patients (48%) had suffered their head injury in falls from a height. However, when considering the seriously injured patients warranting admission to the neurosurgery unit, road traffic injuries predominated (54%) and the age distribution was weighed towards an older age group with 70% being above the age of 20 years and mainly in the economically active 4th decade of life. One hundred and fifty four patients died for a mortality rate of 5% in the entire series of 3008 patients and 25% of the 623 admitted patients. CONCLUSION The experience of head injuries reporting to our centre in two calendar years, 33 years apart, suggests that this attention to the crisis of death and disability occurring on roads is necessary.