The Nottingham Head Injury Register: A Survey of 1,276 Adult Cases of Moderate and Severe Traumatic Brain Injury in a British Neurosurgery Centre

The Nottingham Head Injury Register was established as an audit and research tool for traumatic brain injury (TBI). Study aims included examination of the epidemiology of UK TBI and identification of factors improving management and outcome. Moderate and severe TBI patients admitted to a UK neurosurgery centre were recruited over a 10-year period from 1993 to 2003. A dataset covering all aspects of TBI, including demography, clinical features, investigations, management, complications and outcome were captured prospectively into a computerised database. The study group comprised 1,276 adult patients aged more than 16 years old. The median age of subjects was 35 years, with 78% of the population consisting of male patients. Road traffic accidents were responsible for 49% of injuries; 37% of the study population had moderate TBI and 63% severe TBI. CT brain scan was performed in 92% of cases showing a mass lesion in 41% and diffuse lesion in 59%. Traumatic subarachnoid haemorrhage was present in 34%. At 12 months 32% of patients had died, 13% were severely disabled, 22% were moderately disabled and 33% had made a good recovery. Findings were comparable with other previous large series of TBI patients from international studies. Registry data is useful to define TBI epidemiology and management, and in validation of prognostic scoring systems.