Prospective survey on neurosurgical intensive care for patients with severe head injury

OBJECTIVE: To prospectively compare the clinical outcome of intensive care therapy (ICT) with that of conventional care therapy (CCT) in severe head injured patients. METHODS: Patients with severe head injury were assigned randomly into Group ICT and Group CCT, 100 patients in each group. Patients in Group ICT accepted intensive care therapy in neurosurgical intensive care (NIC) unit for the first 2 weeks after admission, while patients in Group CCT accepted conventional care therapy in ordinary ward. The outcomes were evaluated 3 months after injury. RESULTS: There was a significant increase in good recovery (54%) (chi(2)=4.43, P<0.05) and significant decrease of death (25%) (chi(2)=4.50, P<0.05) in Group ICT compared to 39% and 39% in Group CCT respectively. The differences were also confirmed statistically in the following aspects: the patients under 50 years with good recovery pronounced a number increase (chi(2)=7.54, P<0.01), while the mortality in the same range of age was decreased in Group ICT (chi(2)=5.28, P<0.05). The mortality was reduced significantly in patients with GCS for 6-8 on admission (chi(2)=8.47, P<0.01) and in patients with the level of brain stem injured below mesencephalon (chi(2)=4.15, P<0.05). ICT would improve the outcome in patients undergoing conservative therapy only (chi(2)=13.13, P<0.01). CONCLUSIONS: NIC plays an important role in assessing the neurological state, guiding management, evaluating curative effect and estimating the outcome.