Characteristic of Head Injury Patients Admitted to Intensive Care Unit in Dr.

Introduction: Head socioeconomic Epidemiological studies of head injuries are essential for the effective prevention and treatment of head injury patients, but often found with unclear definitions of head injury. The use of the ICU is associated with higher costs and decreased availability for patients who need it. Oftenly, patients with head injuries require admission to the ICU both before surgery and after surgery. We aim to describe the charachteristic of patients with head injuries who were admitted to the emergency department (ED) and treated in the ICU at Mohamad Hoesin Hospital Methods: This research was an observational descriptive study. Using secondary data from the medical records of Mohammad Hoesin Hospital, Palembang. Performed in the from July 2019 to December 2019. Samples were all patients diagnosed with head injuries. Results: There were 177 subjects participated who met study critera, of which 51 subjects were admitted to ICU. ICU-admitted head injured patients were mostly male (78.5%). The largest age distribution is 11-20 year old (33.3%). The most common type of head injuries admitted to ICU according to CT scan was hemorrhagic head injuries (88.9%). The most common type of head injury admitted to ICU according to GCS was severe head injury (51.1%) Conclusion: Male patients, patients age of 11–20-year-old, severe head injury, and hemorrhagic head injury were the most common characteristic of patients diagnosed with head injuries admitted to ICU at Mohammad Hoesin Hospital


Introduction
Head injury is both major health and socioeconomic problem worldwide as it can occur in both high-and low-income countries and at any age. Head injuries cover 50.000 deaths in the United States annually. Each year, approximately 1.5 million Americans experience head injuries with 200.000 people being treated and survived. Of these, it is estimated that 80.000-90.000 have long-term disabilities. Motor accidents are the leading cause of death in adults aged <40 years.
Head injury is referred to as "silent epidemic", and the term "silent" further reflecting the frequent underestimation of these incidents in actual cases. 1 Epidemiological studies of head injuries are essential for the effective prevention and treatment of head injury patients. Howeverm they are often found with unclear definitions of head injury. A clear definition of the head injury is essential for understanding the epidemiology of this case. Recent head injury is defined as: changes in brain function, or evidence of brain pathology, The utilization of the intensive care unit (ICU) is largely associated with higher costs and decreased availability for patients who actually need it. Oftenly, patients with head injuries require admission to the ICU both before surgery and after surgery. Effective management of critical care may significantly reduce morbidity and mortality in head injury cases. This study aims to describe the charachteristic of patients with head injuries who were admitted to the emergency department (ED) Mohamad Hoesin Hospital (RSMH) and treated in the ICU.

Method
This study is an observational descriptive study to determine the description of head injury patients in the intensive care unit at RSMH Palembang. The study was conducted at RSUP Muhammad Hoesin Palembang in January 2020. The population of this study were all head injury sufferers at Dr. Mohammad Hoesin Palembang. The study sample was all head injury patients who were treated in the intensive care unit Dr. Mohammad Hoesin Palembang who met the inclusion criteria. Inclusion criteria included mild, moderate, severe head injury patients admitted to the ICU and head injury patients who had no indication of ICU care due to other illnesses. The exclusion criteria were other serious disease conditions which were mandatory of ICU care. Data were collected from patient registers and RSMH medical records for cases between July 2019 -December 2019. All of the data then coded into table and analyzed univariately using SPSS 22.0

Results
The study was conducted by collecting data on head injury patients admitted to Mohammad Hoesin General Hospital Palembang between July 1, 2019 and December 2019. There were 177 patients diagnosed with head injuries and 51 patients who were undergoing treatment in the ICU.  In this study, we found that the severity of head injuries that most commonly admitted to the  17 The study by Opondo also stated that the mean age of patients admitted to the ICU due to severe head injury was 34 ± 17 years.
Gender which received the most ICU care due to head injuries in this study was male as many as 40 (78.5%) patients. This was similar to research conducted by Azeez et al which shows the ratio of men to women is 3: 1. Tawil's study also showed that 75% of head injury patients were men with the mean age being 36 years. Moreoever, the most common CT scan abnormalities in this study were patients with bleeding, amounting to 45 patients (88.9%).

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In Azeez et al's study, the mortality rate for head injury patients admitted to the ICU in Kenya was 54.0%, whereas in our study there were only 4 patients or 7.9% who died during treatment. A study conducted by Jochems et al stated that the ICU mortality rate due to head injury was 33% . 6 The Opondo study examined severe head injury patients who were admitted to the ICU and stated that the mortality rate was 54%. 13 Head injury is one of the leading causes of death and disability in United States and Canada, and prevention is the key to reducing the number of the incidence.

Discussion
In this study, we found that the severity of head injuries that most commonly admitted to admitted to the ICU stated that the mortality rate was 54% .13 Head injury is one of the leading causes of death and disability in the United States and Canada, and prevention is the key to reducing the number of the incidence.

Conclusion
Gender with the most frequent head injuries was male patients (78.5%), with the most common severity admitted to ICU was severe head injuries (51.1%) and the most frequent imaging of CT scan lesions was with hemorrhage (88.9%). Further research is needed regarding the prevalence with a longer period and involving other hospitals to determine the demographics and epidemiology of head injuries undergoing intensive care unit care in Indonesia.