| Summary: | 碩士 === 台北醫學大學 === 醫學研究所 === 83 === A population-based study of head injury was conducted in the Taiwan area in order to understand the epidemiological features since July, 1989. The first step was completed in June, 1992. A comparison of head injury patterns between rural and urban area was performed. Taipei City was selected to represent the urban area and Hualien County as its rural counterpart. We found a significant difference between these two areas. The incidence rate was 180/100,000 in Taipei and 333/100,000 in Hualien. and the mortality rate was 38/100,000 in Taipei and 89/100,000 in Hualien. In step 2. two other eastern rural counties and one off-shore county of Taiwan was included through June, 1991 to July, 1993. A result similar to those of Hualien County was obtained. In step 3, a nationwide study was started since June, 1993 and is still under investigation. In step 4, the influences of helmet use enforcement program on head injury was implemented in Taipei City from February to May, 1994.
This report is focused on the data analysis of nationwide study from July 1 1989 to June 30 1994. Patient selectionand ascertainment procedures from study hospitals were through standardized definitions of head injury and associated codes in the International Classfication of Disease, 9th edition (ICD-9). Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) were used in accessing the severity and outcome of head injured patients.
In this study, 43901 cases were collected, 29831 cases were male and 13696 cases were female. The incidence rates was peaked at the age of 20-29 year in both sex, followed by 70 year-old and above. An average of 70% of all head inuries were caused by traffic accidents (T.A.). Nineteen percent were due to fall and 8% by assault. Sixty nine percent of T.A. was caused by motorcycle accidents, 11%pedestrian, 10% automobile and 4% bicycles. A total of 12024 cases (28%) was found to have intracranial hematoma. The interrelationship between degree of conscious disturbance, the severity of skull fracture and intracranial hematoma were significant. The relationship of skull fracture and epidural hematoma was significant in comparing with other site of hematoma. A helmet use enforcement program was conducted in Taipei City and a 30% reduction in hospitalization, mortality and craniotomy rate were noted.
A very high proportion of head injury in Taiwan area is caused by motorcycle accidents, but very few motorcyclists are using helmet. Prevention modalities should put helmet law legislation in the first priority and the measures designed to increase the use of helmets among youngster.
|
|---|
