The Severity of Head Injuries Based on Injury Location:  a Cross-Sectional Study

Erik Irham Lutfi; Meirna Eka Fitriasnani; Hengky Irawan; Achmad Wahdi; Ely Isnaeni

doi:10.30994/jnp.v8i3.821

Authors

Erik Irham Lutfi Department of Nursing, Universitas Kadiri, Indonesia
Meirna Eka Fitriasnani Department of Midwifery, Universitas Kadiri, Indonesia
Hengky Irawan Department of Nursing, Universitas STRADA Indonesia
Achmad Wahdi Department of Nursing, Universitas Kadiri, Indonesia
Ely Isnaeni Department of Nursing, Bhakti Wiyata Institute, Indonesia

DOI:

https://doi.org/10.30994/jnp.v8i3.821

Keywords:

location of head bleeding, Traumatic Brain Injury (TBI), RTS (Revised Trauma Score)

Abstract

Background: The mortality and morbidity rates in patients with traumatic head injuries are still high, caused by primary damage due to internal bleeding. Intracerebral hemorrhage is a common complication of traumatic brain injury. The severity of head injury patients is a predisposing factor that causes high mortality and morbidity rates. The presence of bleeding in the head affects the severity of the patient's injury, bleeding in the head will reduce blood flow to the head, which will cause decreased blood perfusion to the brain. In severe head injury, a hematoma of more than 50 mL is associated with higher mortality. Acute ICH (Intra Cerebral Haemoraghea) can be a catastrophic event with the mortality largely predicted by the hematoma size, location, and the patients' GCS (Glasgow Coma Scale) on admission.

Objective: This study aims to determine the relationship between the location of intracerebral hemorrhage and the severity of head injury.

Methods: This study uses a correlational analytical approach with a cross-sectional design, utilizing secondary data from medical records of patients with traumatic head injuries from January to December 2022. The calculation of severity using RTS (Revised Trauma Score). These three scores (Glasgow Coma Scale, Systolic Blood Pressure, Respiratory Rate) are then used to take the weighted sum by RTS = 0.9368 GCSP + 0.7326 SBPP + 0.2908 RRP Values for the RTS are in the range 0 to 7.8408. Scores range from 0-4. The study population was patients with moderate to severe traumatic head injuries. Data were analyzed using a correlation test based on Spearman's rank correlation. Results: The results showed a significant relationship between the location of head trauma lesions and the severity of head injury patients (p value = 0.008, correlation coefficient 0.378).

Conclusion: Mortality and morbidity rates in patients with traumatic head injuries are still high, caused by primary damage due to internal bleeding. The majority of patient with Trauma brain Injury is male and were in the productive age range ranging from 12-35 years. Epidural hematoma (EDH) is one of the most life-threatening lesions in patients with craniocerebral disease.

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References

Casey M. Woster, Michael D. Zwank, Joseph R. Pasquarella, Sandi S. Wewerka, Jeffrey P. Anderson, Jessica T. Greupner, Sakib Motalib,Placement of a cervical collar increases the optic nerve sheath diameter in healthy adults,The American Journal of Emergency Medicine,Volume 36, Issue 3,2018,Pages 430-434,ISSN 0735-6757,https://doi.org/10.1016/j.ajem.2017.08.051.(https://www.sciencedirect.com/science/article/pii/S0735675717307003).

Daishan Jiang, Tianxi Chen, Xiaoyu Yuan, Yanbo Shen, Zhongwei Huang,Predictive value of the Trauma Rating Index in Age, Glasgow Coma Scale, Respiratory rate and Systolic blood pressure score (TRIAGES) and Revised Trauma Score (RTS) for the short-term mortality of patients with isolated traumatic brain injury,The American Journal of Emergency Medicine,Volume 71,2023,Pages 175-181,ISSN 0735-6757,https://doi.org/10.1016/j.ajem.2023.06.030.(https://www.sciencedirect.com/science/article/pii/S0735675723003261).

Debojit Basak, Shamita Chatterjee, Jonatan Attergrim, Mohan Raj Sharma, Kapil Dev Soni, Sukriti Verma, Martin GerdinWärnberg, Nobhojit Roy, Glasgow coma scale compared to other trauma scores in discriminating in-hospital mortality of traumatic brain injury patients admitted to urban Indian hospitals: A multicentre prospective cohort study,Injury, Volume 54, Issue 1, 2023, Pages 93-99, ISSN 0020-1383, https://doi.org/10.1016/j.injury.2022.09.035. (https://www.sciencedirect.com/science/article/pii/S0020138322006945).

Eom KS, Kim JH, Yoon SH, Lee SJ, Park KJ, Ha SK, Choi JG, Jo KW, Kim J, Kang SH, Kim JH. Gender differences in adult traumatic brain injury according to the Glasgow coma scale: A multicenter descriptive study. Chin J Traumatol. 2021 Nov;24(6):333-343. doi: 10.1016/j.cjtee.2021.06.004. Epub 2021 Jun 9. PMID: 34275712; PMCID: PMC8606602.

Erik Irham Lutfi, & Meirna Eka Fitriasnani. (2024). Analysis of the Emergency Level of Pediatric Covid 19 Patients in the Emergency Room at Gambiran Hospital, Kediri. STRADA Jurnal Ilmiah Kesehatan, 13(1), 8–14. https://doi.org/10.30994/sjik.v13i1.1104.

Fatwati. (2021). Gambaran Injury Severity Scale Pada Pasien Cedera Kepala Berat. University Research Colloqium (URECOL), 467–471. http://repository.urecol.org/index.php/proceeding/article/view/1434/1401.

Ginsburg J, Huff JS. Closed Head Trauma. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557861/.

Jeong YH, Oh JW, Cho S; Korean Trauma Data Bank System Committee. Clinical Outcome of Acute Epidural Hematoma in Korea: Preliminary Report of 285 Cases Registered in the Korean Trauma Data Bank System. Korean J Neurotrauma. 2016 Oct;12(2):47-54. doi: 10.13004/kjnt.2016.12.2.47. Epub 2016 Oct 31. PMID: 27857907; PMCID: PMC5110918.

Khairat A, Waseem M. Epidural Hematoma. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518982/.

Lutfi, et al. 2019. The Duration of Accident AND Kind of Transportation as Death Predictor of the Patients with Severe Head Injury. Atlantis press. https://www.atlantis-press.com/proceedings/icss-19/125926954.

MJS Niemeyer, 2022. Mortality in plolytrauma patients with moderate to severe TBI on par With isolated TBI Patients : TBI as Last Frontier in polytrauma patients. https://doi.org/10.1016/j.injury.2022.01.009. www.elsevier.com/locate/injury.

Nantulya VM, Reich MR. The neglected epidemic: road traffic injuries in developing countries. BMJ. 2002 May 11;324(7346):1139-41. doi: 10.1136/bmj.324.7346.1139. PMID: 12003888; PMCID: PMC1123095.

Putra RO, Imran Y, Rahmansyah M, Khusfiani T, Putri MA, Az zahra A. Role of Intravenous Immunoglobulin (IVIG) in Patients with Guillain Barre Syndrome with Severe Community Pneumonia in The Intensive Care Unit (ICU). Journal of Society Medicine. 2024; 3(3): 66-70. DOI: https://doi.org/ 10.47353/jsocmed.v3i3.123.

Rohadi Muhammad Rosyidi, Bambang Priyanto, Asra Al Fauzi, Agung Budi Sutiono,Toward zero mortality in acute epidural hematoma: A review in 268 cases problems and challenges in the developing country, Interdisciplinary Neurosurgery,Volume 17,2019,Pages 12-18,ISSN 2214-7519,https://doi.org/10.1016/j.inat.2019.01.021.(https://www.sciencedirect.com/science/article/pii/S2214751918302871.

Siahaya, N., Huwae, L. B. S., Angkejaya, O. W., Bension, J. B., & Tuamelly, J. (2020). Prevalensi Kasus Cedera Kepala Berdasarkan Klasifikasi Derajat Keparahannya Pada Pasien Rawat Inap Di Rsud Dr. M. Haulussy Ambon Pada Tahun 2018. Molucca Medica. doi: https://doi.org/10.30598/molmed.2020.v13.i2.14. https://ojs3.unpatti.ac.id/index.php/moluccamedica/article/view/2500.

Tenny S, Thorell W. Intracranial Hemorrhage. [Updated 2024 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470242/.