TY - JOUR
T1 - Relative incidence of intracranial mass lesions and severe torso injury after accidental injury
T2 - Implications for triage and management
AU - Gutman, Michael B.
AU - Moulton, Richard J.
AU - Sullivan, Irene
AU - Brown, Theresa
AU - Hotz, Gillian
AU - Tucker, William S.
PY - 1991/7
Y1 - 1991/7
N2 - In a previous study of head injury patients we found that old age, low Glasgow Coma Scale (GCS) score, pupillary inequality, and falls were significant predictors of intracranial mass lesions (IMLs). Injury to motor vehicle occupants was less likely to result in IML. The present study defines predictors of severe torso injury (STI) in 646 patients admitted to a trauma unit and compares these with predictors of IML obtained in the previous study. Tachycardia and low blood pressure were associated with an increased incidence of STI (p = 0.003, p = 0.0000). The incidence of STI in falls differed from that of IML (13.2% vs. 47.7%, p < 0.001). There was a greater incidence of STI than IML in MVAs (33.6% vs. 14.8%, p < 0.001). Patients 70 years of age or older had a higher incidence of IMLs than STIs (p < 0.001). Patients less than 30 years old had a significantly greater incidence of STIs than IMLs (p < 0.001). These data suggest that in MVA victims who are less than 30 years old, are hypotensive, and tachycardic, the diagnosis and emergent treatment of severe torso injury should take precedence over measures designed to detect and treat intracranial mass lesions. The converse is true for older patients injured in falls.
AB - In a previous study of head injury patients we found that old age, low Glasgow Coma Scale (GCS) score, pupillary inequality, and falls were significant predictors of intracranial mass lesions (IMLs). Injury to motor vehicle occupants was less likely to result in IML. The present study defines predictors of severe torso injury (STI) in 646 patients admitted to a trauma unit and compares these with predictors of IML obtained in the previous study. Tachycardia and low blood pressure were associated with an increased incidence of STI (p = 0.003, p = 0.0000). The incidence of STI in falls differed from that of IML (13.2% vs. 47.7%, p < 0.001). There was a greater incidence of STI than IML in MVAs (33.6% vs. 14.8%, p < 0.001). Patients 70 years of age or older had a higher incidence of IMLs than STIs (p < 0.001). Patients less than 30 years old had a significantly greater incidence of STIs than IMLs (p < 0.001). These data suggest that in MVA victims who are less than 30 years old, are hypotensive, and tachycardic, the diagnosis and emergent treatment of severe torso injury should take precedence over measures designed to detect and treat intracranial mass lesions. The converse is true for older patients injured in falls.
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U2 - 10.1097/00005373-199107000-00016
DO - 10.1097/00005373-199107000-00016
M3 - Article
C2 - 2072438
AN - SCOPUS:0026326847
VL - 31
SP - 974
EP - 977
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 7
ER -