Objectives: This study evaluates the geo-social factors that contribute to the incidence and outcome of the severely head injured patient by the first direct comparison of head injury outcome between a western centre and that of a developing country.
Method: A retrospective analysis of head injuries admitted to two centres (Doha and Newcastle) over a five year period (January 1997-December 2001) was carried out comparing demographic details, aetiology, severity of injury and management outcome. The mode of participation of victims was identified and the geo-social factors that contributed to the aetiology and severity of head injury were evaluated in detail. Data analysis was with SPSS version 11.
Results: There was a significant male preponderance in Doha (12m:lf) compared with Newcastle (2.7m:lf). The peak age group in Newcastle for all head injuries was 0-10yrs, whereas in Doha the peak age was 20-30yrs. Road traffic accident accounted for nearly 70% of all head injuries in Doha whereas falls accounted for nearly 50% of all head injuries in Newcastle. Overall the good outcome was 74% in Doha and 81% in Newcastle (NS). The proportion of patients presenting in coma and mortality (26% ) in Doha was more than twice that in Newcastle. A recent change in the law in Qatar allowing female drivers has not significantly increased the incidence of head injury.
Conclusion: The combination of powerful cars and good roads with a young population has resulted in an excessive mortality in Doha compared with Newcastle. Recent changes in the law in Qatar have not significantly altered the incidence of head injury related to road traffic accidents. The high male preponderance in Qatar reflects the relatively protected role women enjoy in this society.
Igbaseimokumo U, Bashir EF, Taha Z, Raza A, Mohammed A, Mendelow D, Chambers I, Gregson B, Treadwell L. The influence of social and cultural factors on the incidence and severity of traumatic brain injury: a comparative study of traumatic brain injury in Doha, Qatar and Newcastle upon Tyne, UK. J Neurotrauma 2002; 19: 1312.
Dr. Iain R. Chambers, Cleveland Unit, Middlesbrough. Tel: +44 (0)1642-854-778.
Regional Medical Physics Department, Newcastle General Hospital, Newcastle upon Tyne, NE4 6BE, UK.
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