Pediatric neurosurgery
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We have analyzed predictors of mortality following closed head injury in a series of 1,031 consecutive patients with closed head injury admitted to hospital from January 1986 through December 1990. All patients were treated in a uniform manner and surgical intervention was performed as soon as possible in patients with intracranial mass lesions. Logistic analysis was used to identify patient and injury characteristics that were independent predictors of mortality within this patient group. ⋯ Sixty-four percent of the variability in reported mortality rates could be accounted for by differences in mean age of the patients and mass lesion incidence (p = 0.0035). We conclude that apparent improvements in head injury mortality in the last 2 decades may be partly or wholly due to different population characteristics in the reported series. Multiple injuries appear to be important contributors to patient mortality, and in the interest of improved description of head injury populations, the Injury Severity Score should be reported with age, mass lesion incidence, and Glasgow Coma Score.