Outcome of head injury in unknown patients at Level-1 apex trauma centre

This was a retrospective study, carried out at the Department of Neurosurgery at Jai Prakash Narain Apex Trauma Centre (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi. Many patients with head injury whose identity cannot be ascertained, are admitted in our hospital. Care and management of these neglected patients from pre-hospital till discharge, rehabilitation or death is fraught with many challenges. Very few studies in world literature are available on this subgroup of patients. We analyzed data pertaining to 70 consecutive patients at our hospital. Out of 70 patients, 68 (97%) were male, most were in the age group of 21-30 years 25 (36%). The mean age was 33.7 +/- 14.6 years (range 5-70 yrs). Mean duration of hospital stay was 27.9 +/- 52.2 days (range 2-368 days). Principal cause of head injury was road traffic accident seen in 47 patients (67%). Majority of the patients had Glasgow coma scale less than 8 on admission. Forty three patients were treated conservatively and 20 patients needed surgery. Ten patients 10 (14%) died in hospital, 7 (10%) patients had good recovery. During the course of treatment identity of 51 (73%) patients could be established and they were either discharged to home 42 (60%) or referred to their 9 (12%) district hospital. Nine patients(12%) remained unknown and on recovery were sent to destitute homes for rehabilitation.