Davis et al identified risk factors associated with death in a patient with head trauma who is able to talk initially (the "talk and die" subset of head injury). In theory these patients are potentially salvagable with aggressive management. The authors are from the University of California San Diego and multiple trauma hospitals in the San Diego area.


Patient selection:

(1) significant head injury, with an Abbreviated Injury Score (AIS) 3 or higher

(2) one or more preadmission verbal component of the Glasgow Coma Score 3 to 5 (inappropriate words or better; excludes incomprehensible sounds and no sounds)


General risk factors for mortality:

(1) therapy with an anticoagulant prior to trauma

(2) head AIS 5

(3) field intubation

(4) high energy mechanism (fall, gunshot, struck pedestrian)


Additional risk factors for early death (on day of admission):

(1) severe extracranial injuries

(2) severe hypotension


Additional risk factors for later death (on day 5 or later after admission):

(1) older age (>= 55 years of age)

(2) pulmonary embolism


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