Factors affecting mortality after traumatic brain injury in a resource-poor setting

Area of Science:

• Neuroscience
• Public Health
• Trauma Surgery

Background:

• Traumatic brain injury (TBI) is a leading cause of long-term disability and societal economic burden.
• Resource-poor settings face unique challenges in managing TBI patients.
• Understanding mortality factors in these settings is crucial for improving outcomes.

Purpose of the Study:

• To identify factors influencing mortality in patients with traumatic brain injury (TBI).
• To assess the impact of resource limitations on TBI patient outcomes in northern Uganda.

Main Methods:

• Retrospective chart review of 194 TBI patients from 2013-2017 at St Mary's Hospital, Lacor, Uganda.
• Data included demographics, injury-to-presentation time, vital signs, management, and mortality.
• Severe head injury defined by Glasgow Coma Scale < 9.

Main Results:

• The overall mortality rate was 33.0%, with 72% of deaths occurring in patients with severe head injury.
• Factors associated with mortality included low mean arterial pressure, referral status, respiratory distress, severe head injury, and pupil reactivity.
• Surgical interventions, including burr-holes, had a high mortality rate (7/10 patients).

Conclusions:

• TBI disproportionately affects young males in resource-poor environments.
• Limited access to CT scans and intracranial pressure monitoring compromises surgical decision-making and leads to poor outcomes.
• Addressing resource limitations is essential for reducing TBI-related mortality.