Causes and consequences of head injuries among rural inhabitants hospitalised in a Multi-organ Injury Ward. II. Circumstances, types and consequences of head injuries.

The scope of problems concerning head injuries was investigated among rural patients, compared to urban population, from the aspect of their incidence in both populations, as well as an attempt to perform a multi-variable analysis of socio-demographic and geographical risk factors for each of the analysed traits concerning the injury. The study group were patients treated in the Multi-Organ Injury Ward, at Cardinal Stefan Wyszyński Regional Hospital in Lublin during the period 1999-2002. The study covered 265 patients. The group of rural inhabitants covered 34% of the total population in the study. The most frequent circumstances of the injury sustained, both among rural and urban patients, was a road accident with the patient either as a passenger or a pedestrian, observed in 30.6% of the total number of people in the study. Female gender was an injury risk factor. The second position among circumstances of injuries was occupied in both sub-populations by road accident with the patient as the driver - this concerned 23% of the total number of patients in the study, and the risk factors were: male gender, place of residence in rural area and better educational status. The majority of patients sustained an injury in the street, with similar frequency among rural and urban inhabitants. Rural patients, significantly more often than urban inhabitants, sustained injuries at home and in the courtyard. The most frequent type of an injury sustained was cerebral concussion, which was noted twice as frequently among urban (59.9%) than rural inhabitants (31.1%). The risk factors of cerebral concussion were: urban place of residence, female gender, and younger age of a patient. Injuries of mesencephalon were placed in the second position with respect to the frequency of occurrence, and more often concerned rural (46.7%) than urban (24.6%) patients. The risk factors for this injury were: living in a rural area, and older age in males. Concomitant injuries were observed in 50% of rural patients and in 57.1% of urban inhabitants. The consequences of injuries in various forms were observed in 87.8% of rural inhabitants, and in a similar percentage of urban patients. Age turned out to be the risk factor for the appearance of the negative consequences of the injury. This was also the risk factor of death during treatment, and in balance disorders.