Incidence of mild head injury, management, and expenses in Kashan, 2003-2004

Head injury is a major cause of traumatic death and disability. However, there is no definite and unified strategy in the management of mild head injury victims. All cases of head injury in a 24-month interval between April 2003 and March 2005 were included to the study, and those with Glasgow Coma Scale Score (GCSS) of 14 or 15, without associated trauma were analyzed. Of 4290�victims�3894 (90.8%) had mild head injury with GCSS of 14 or 15. The incidence of head injury in our region is 429 for each 100,000 people. Of 1629 (48%) of the patients with skull X-ray 200 (12.2%) had a fracture. From 400 (10.3%) head CT scans, 118 were abnormal. Of all the patients, 2676 had only head injury. The cost for only one night of hospitalization on the base of the expenses in 2003 was 326,654 Rls for each patient, while at the same time the charge for a brain CT scan was 150,000 Rls. It is recommended that, at least in neurosurgical centers, all patients with head injury screened and candidate for admission, undergo a head CT scan study after their early evaluations and only those with abnormal findings on CT scan be admitted for further observation. With this strategy, we predict an at least 50% decrease in the costs compared with hospital admission and observation of all patients.