Assessment of prognosis in head trauma patients by Madras Head Injury Prognostic Scale (MHIPS)

Background Traumatic head injuries are the most common cause of mortality and disability among patients suffering trauma. Applying proper trauma scoring systems plays an important role in the management of these patients thus by means of special treatment guidelines, we can improve traumatic patient’s prognosis. Objective To determineprognosis in head trauma patients by Madras Head Injury Prognostic Scale (MHIPS) and to compare this scale with Glasgow Outcome Scale (GOS) at discharge. Methods In this cross-sectional study we evaluated 117 patients with head trauma who were admitted in Shahid Mohammadi Emergency Department (ED) in Bandar Abbas. MHIPS (containing 6 prognostic factors) was used to determine patient’s prognosis at the initial visit in the ED. We used GOS in order to measure patient’s outcome at discharge. All patient’s data were recorded through questionnaire with two separate section: Demographic and Clinical data. We compared the correlation of these two prognostic scales. Results Of 117 patients, 98 (83.8%) were male and 19 (16.2%) were female. The mean age range of patients was 31.15±17.7. 61 patients (52.1%)had intracranial injuries with subdural hematoma (SDH) being the most common. The highest rate of full recovery (67 patients (87%)) was observed in the group with MHIPS score above 15 and the highest rate of mortality (26 patients (86.7%)) was observed in the group with MHIPS less than 12. There was a significant difference between the two scale when comparing patient’s prognosis (p-value<0.001). MHIPS had correctly estimated patient’s prognosis in 92.3% of cases. Conclusions: MHIPS has the ability to determine patient’s prognosis in head trauma with high sensitivity and specificity. Thus, it is suggested that an appropriate scale like MHIPS should be provided for the emergency physicians to determine patient’s prognosis in head trauma.