Epidemiological Analysis of 135 Cases of Severe Traumatic Brain Injury Managed at a Surgical Intensive Care Unit

Abstract

This study was a retrospective analysis of the epidemiologic profile of severe traumatic brain injuries managed at the surgical intensive care unit of the University Hospital Center of Yaoundé, Cameroon, between January 2011 and December 2015. All the patients admitted at the surgical intensive care unit for a traumatic brain injury with an initial Glasgow coma scale score ≤ 8 were included. One hundred and thirty-five cases were enrolled. One hundred and fourteen were males and 21 were females. Their mean age was 32.75 years. Forty-four patients were aged between 16 to 30 years. Road traffic accidents represented the first mode of injury with 101 cases and most of the patients were pedestrians hit by a car. Pupils and students were the most involved. Twenty-three patients had additional extracranial injury. On admission, 97 (71.85%) patients had GCS 7-8. A brain CT scan was done for 115 patients. Intracranial and intracerebral hemorrhages were the most frequent radiological findings with 57 cases. The overall mortality was 32.59% with 44 deaths. Thirty-two of the deaths occurred in patients with GCS 7 -8 on admission. Ninety-one (67.40%) patients survived, 74 (54.81%) had persisting disabilities, while only 17 (12.59%) recovered fully. The following factors had an impact on the outcome: GCS at admission, pupillary anomalies, length of hospital stay, endotracheal intubation and surgery. Severe TBI remains a heavy socio-economic burden worldwide. In Cameroon where the health system is poorly organized, the outcome of individuals who sustained a severe TBI was dismal.

Pediatric Traumatic Brain Injury Pattern at the General Hospital, Douala, Cameroon

“…Concerning the clinical findings, the initial loss of consciousness was the most common symptom observed in 50 (48.50%) children, and this finding was consistent with reported data [12]…”

“…In Cameroon, few studies have been done on PTBI. Ndoumbé et al have found a prevalence of 14.81% of PTBI in severe TBI patients admitted at the surgical intensive care unit of the University Teaching Hospital, Yaoundé, between January 2011 and December 2016 [12].…”

Traumatic Brain Injury in Cameroon: A Prospective Observational Study in a Level I Trauma Centre

“…The 6-month GOSE outcomes showed that 44 (29%) patients had an upper-good recovery, 21% had an upper-moderate disability, and 12 (8%) had an upper-severe disability, consistent with reports from Paris, France [ 49 ] and Tanzania [ 6 ]. Ndoumbe et al [ 14 ] from Cameroon noted that only 12.6% of their patients fully recovered and 55% of cases had permanent disability; however, only severe TBI patients were considered in this study. Using the QoLIBRI, 36 (28%) of patients were impaired, while 46 (36%) had above-average scores, consistent with reports by Born et al [ 50 ] in Switzerland.…”

“…Despite the social and economic impact of TBI in Cameroon, data on its characteristics and medium- or long-term outcomes are lacking; only a few studies from SSA report traumatic brain injuries as a major cause of death and disability. Ndoumbe et al [ 14 ] and Motah et al [ 15 ] addressed TBI management and outcomes, but only severe TBI or intracranial haemorrhage were considered, and cases of medium- or long-term outcomes were not included. Furthermore, the study of Ndoumbe et al [ 14 ] was retrospective in design; hence, outcome evaluations were not appropriate for patient characteristics and medium-term outcomes after TBI [ 16 ].…”

“…Ndoumbe et al [ 14 ] and Motah et al [ 15 ] addressed TBI management and outcomes, but only severe TBI or intracranial haemorrhage were considered, and cases of medium- or long-term outcomes were not included. Furthermore, the study of Ndoumbe et al [ 14 ] was retrospective in design; hence, outcome evaluations were not appropriate for patient characteristics and medium-term outcomes after TBI [ 16 ].…”