Patterns of Primary Head and Neck Injuries in India

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Introduction: Head and neck (H&N) injuries are common and potentially fatal, but their prevalence and patterns are not well-documented in low- and middle-income countries (LMICs), where trauma causes enormous morbidity and mortality. Our objective was to describe the trends of non-traumatic brain injury, non-ophthalmic H&N injuries among Indian trauma patients. Methods: We analyzed “Towards Improved Trauma Care Outcomes (TITCO) in India,” a prospective database from four Indian public hospitals from 2013 to 2015. Using International Classification of Diseases 10 (ICD-10) codes, we identified patients with H&N injuries and divided them into polytrauma and isolated H&N injury groups. Patient demographics, injury characteristics, and clinical outcomes were collected. Results: Of 16,047 patients, we identified 870 patients with H&N trauma (171 isolated, 699 polytrauma) for a prevalence of 5.4%. Males and adults aged 18-55 were most affected. Blunt injuries (94.5%) and road traffic injuries (37.3%) were the most frequent type and mechanism of injury, respectively. Glasgow coma score was worse among patients with isolated H&N injuries. The mortality was 25.2% (28.5% polytrauma vs 11.7% isolated, p<0.001). Conclusion: H&N trauma in India most impacts males and adults aged 18-55, is most frequently caused by road traffic accidents, and is associated with high mortality compared with studies from high-income countries. This suggests opportunities for improvement in LMIC trauma systems for management of H&N injuries and demonstrates likely under-coding of traumatic brain injury in the dataset.

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