Laeke T, Tirsit A, Kassahun A, Sahlu A, Debebe T, Yesehak B, Masresha S, Deyassa N, Moen BE, Lund-Johansen M, Sundstrøm T. World Neurosurg. 2021; ePub(ePub): ePub.
BACKGROUND: Traumatic brain injury (TBI) is a public health problem in Ethiopia. We need more knowledge about the epidemiology and neurosurgical management of TBI patients to identify possible focus areas for quality improvement and preventive efforts.
METHODS: This was a prospective cross-sectional study (2012-2016) at the four teaching hospitals in Addis Ababa, Ethiopia. All surgically treated TBI patients were included, and details on clinical presentation, injury types and trauma causes were registered.
RESULTS: We included 1087 patients (mean age 29 years; 8.7% females; 17.1% < 18 years of age). Only 15.5% of TBIs were classified as severe (Glasgow Coma Scale (GCS) score 3-8). Depressed skull fracture (DSF; 44.9%) and epidural hematoma (EDH; 39%) were the most frequent injuries. Very few patients were polytraumatized (3.1%). Assault was the most common injury mechanism (69.9%) followed by road traffic accidents (RTA; 15.8%) and falls (8.1%). More than 80% of patients came from within 200 kms of the hospitals, but the median time to admission was 24 hours. Most assault victims (80.4%) were injured more than 50 kms from the hospitals, whereas 46% of RTA victims came from the urban area. Delayed admission was associated with higher GCS scores and non-severe TBI (p < 0.01).
CONCLUSIONS: The injury panorama, delayed admission and few operations for severe TBI are linked to a substantial patient selection both before and after hospital admission. Our results also suggest that there should be a geographical framework for tailored guidelines, preventive efforts and development of prehospital and hospital services.
Language: en
Keywords
epidemiology; Traumatic brain injury; head injury; low- and middle-income countries; neurotrauma