Suspected alcohol and addictive narcotic use were more at risk to severe head injury

Abstract

Latar belakang: Cedera kepala menyebabkan dampak seperti gangguan kognitif, perilaku dan keterbatasan fisik. Tujuan studi ini untuk menentukan faktor utama yang berkontribusi terhadap keparahan cedera kepala pada pasien yang dirawat inap di rumah sakit.

Metode: Studi ini merupakan bagian dari penelitian “Pengembangan Database Registri Trauma sebagai Penunjang Sistem Surveilans Cedera”. Data dikumpulkan dengan cara abstraksi dari rekam medis oleh petugas terlatih dengan formulir registri pada pasien cedera yang dirawat inap di 3 rumah sakit dari bulan Januari – Agustus 2010. Keparahan cedera diklasifikasikan berdasarkan Glasgow Coma Scale (GCS) dengan batasan nilai 3-9 mengalami cedera kepala berat, 10-12 cedera kepala sedang dan 13-15 cedera kepala ringan.

Hasil: Dari 450 pasien cedera rawat inap terdapat 36 pasien (8%) yang mengalami cedera kepala berat. Pasien dengan indikasi mengkonsumsi alkohol/narkotik mempunyai risiko hampir 5 kali mengalami cedera kepala berat [rasio odds suaian (ORa) = 4,77; 95% interval kepercayaan (CI)=1,04–21,75] dibanding tanpa indikasi. Pasien yang tidak dirujuk mempunyai risiko 5,5 kali  mengalami cedera kepala berat (ORa=5,50; 95% CI=2,28–13,27) dibanding pasien yang dirujuk. Pasien cedera karena kecelakaaan lalu lintas dibanding bukan kecelakaan lalu lintas mempunyai risiko 3 kali mengalami cedera kepala berat (ORa=3,43; 95% CI=1,14–10,32).

Kesimpulan: Indikasi mengkonsumsi alkohol/narkotik berkontribusi paling besar terhadap keparahan cedera kepala. Kampanye anti alkohol/narkotik dan perlu dilakukan untuk mencegah cedera kepala berat. (Health Science Indones 2011;2:34-40)

Abstract

Background: The impact of head injuries were cognitive disorder, behavioral disorder and physical limitation. The objective of this study was to identify a major factor that contributes to head injury severity in hospitalized patients.

Methods: This study was part of research "Development of Trauma Registry Databases as a Support System for Injury Surveillance”. Data collected by abstraction of medical records by trained personnel using registry form in patients who had hospitalized in 3 hospitals from January to August 2010. Severe head injury classified by the Glasgow Coma Scale (GCS) score 3-9 diagnosed severe head injury, 10-12 moderate head injury and 13-15 mild head injury.

Results: Out of 450 injured patients, 36 patients (8%) who had severe head injuries. Patient who was suspected alcohol and addictive narcotic use had nearly 5-fold increase the risk in severe head injury [adjusted odds ratio (ORa)=4.77; 95% confidence interval (CI)=1.04-21.75] compared to not suspected. Patient who was referred had a 5.5-fold increase the risk in severe head injury (ORa=5.50; 95% CI=2.28-13.27) compared with not referred. Injured person due to traffic accident than other type of accident had 3-fold increase the risk of severe head injury (ORa=3.43; 95% CI=1.14-10.32).

Conclusion: Suspected alcohol or addictive narcotic was the highest risk to severe head injury. Campaign against alcohol and addictive narcotic should be done to prevent head injury severity. (Health Science Indones 2011;34-40)