English summary: INITIAL TREATMENT AND TRANSPORTATION OF PATIENTS WITH SERIOUS BRAIN INJURY IN THE HELSINKI AREA

Background Brain injury is the major cause of death among young adults in the Western world. Prevention and treatment of hypotension and hypoxia, the most important causes of secondary injury, have improved outcome after head trauma.

Methods In this retrospective study we reviewed the patient records of unconscious patients with head trauma transported to Helsinki University Hospital in the years 2002-2003. The incidence of hypoxia and hypotension and other relevant factors during transportation were recorded. Outcome was evaluated 6 and 12 months after trauma.

Results Ninety-two patients (73 male) were included in the study. The majority of the patients had an acute subdural haematoma. 59 patients were transported directly from the scene of the injury, the rest from another hospital. Twenty-four patients suffered from hypoxia and 17 were hypotensive. At 12 months, 37 patients had a good outcome, and 41 had died. Age over 60 years and transportation from another hospital had adverse effects on the outcome.

Conclusions Prevention and treatment of hypoxia and hypotension are essential to avoid secondary injury.