Patterns of Head and Neck Injuries in Urban India: A Multicenter Study

Abstract

Objective: The pattern of head and neck injuries has been well studied in high-income countries, but the data are limited in low- and middle-income countries, which are disproportionately affected by trauma. We examined a prospective multicenter database to describe patterns and outcomes of head and neck injuries in urban India. Study Design: Retrospective review of trauma registry. Setting: Four tertiary public hospitals in Mumbai, Delhi, Kolkata. Methods: We identified patients with isolated head and neck injuries using International Classification of Diseases, 10th Revision (ICD-10) codes and excluded those with traumatic brain and/or ophthalmic injuries and injuries in other body regions. Results: Our cohort included 171 patients. Most were males (80.7%) and adults aged 18 to 55 years (60.2%). Falls (36.8%) and road traffic accidents (36.3%) were the 2 predominant mechanisms of injury. Overall, 35.7% required intensive care unit (ICU) admission, and 11.7% died. More than 20% of patients were diagnosed with “unspecified injury of neck.” Those with the diagnosis had a higher ICU admission rate (51.4% vs 31.3%, P =.025) and mortality rate (27.0% vs 7.5%, P =.001) than those without the diagnosis. Conclusion: Isolated head and neck injuries are not highly prevalent among Indian trauma patients admitted to urban tertiary hospitals but are associated with high mortality. Over a fifth of patients were diagnosed with “unspecified injury of neck,” which is associated with more severe clinical outcomes. Exactly what this diagnosis entails and encompasses remains unclear.