Role of an expert system in management of head injury patients

Objective: The objective of our study is to develop an expert system for Management of Head Injury Patients (MHIP) to automate treatment planning support for severe head injury patients. Methods: A study was conducted among the Head injury Patients of Government General Hospital (GGH), Chennai, India. The necessary information were recorded and the risk factors were identified by various multivariate statistical models using SPSS package, with all these information together with the opinion of the Neurosurgeon on important clinical factors an Expert system MHIP has been developed. Results: Our study reveals that out of 801 head injury cases, 261 were severe head injury cases (GCS ≤8). It was alarming to observe that around 60% of the severe head injury cases were dead. Risk of Persistent Vegetative State /Death is 2 (95% CI = 1.18 - 4.33) times more in older people than the younger ones. The cases with abnormal respiratory rate had 5 (95% CI = 2.54 - 8.40) times more chances for death than cases with normal respiratory rate of 10-24/min. Thus the older age (P=0.001), abnormal respiratory rate (P=0.003) and lower GCS (P=0.008) were found to be consistent risk factors and significantly associated with the mortality of severe head injury patients. Conclusion: From the perspective of patients’ well being, Persons trained in trauma care in the rich industrialized countries depend a great deal on expensive, sophisticated diagnostic and curative equipment and materials. It will not be possible for most hospital in Low income Countries to obtain and stock such equipment and materials. Therefore an Expert system MHIP, developed in our study would help the neurosurgeon to a greater extent in identifying the patients, whose life can be saved, and which are cost-effective and feasible in such Institutions.