Outcome of severe traumatic brain injury at a critical care unit: a review of 87 patients

Opondo, EA; Mwang'ombe, N. J. M.

doi:10.4314/aas.v1i1.45788

Cited by 15 publications

(20 citation statements)

References 10 publications

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“…What is glaringly absent from all the articles written on TBI in Kenya, with the possible exception of the study by Gachanja, is what happens to those TBI patients who survive and are discharged from hospital. In other words, all scholarly literature available on TBI in Kenya pertains to the (hospital) treatment of people with brain injuries with no mention of any post-hospital rehabilitation services for TBI survivors, most of whom have moderate to severe limitations (Gachanja, 2013;Kiboi et al, 2011;Opondo & Mwangombe, 2007). As there are no outpatient brain rehabilitation programs affiliated with the hospitals such as KNH, and none in the private sector, TBI survivors in Kenya currently have nowhere to go for brain injury rehabilitation services such as cognitive rehabilitation that can enable them to gain an amount of independence and improve their quality of life, including obtaining employment when possible.…”

Section: Discussion and Recommendationsmentioning

confidence: 99%

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Traumatic Brain Injury in Kenya

Kinyanjui

2016

Sage Open

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Kenya has a disproportionately high rate of road traffic accidents each year, many of them resulting in traumatic brain injuries (TBIs). A review of articles written on issues pertaining to the medical treatment of people with TBI in the past 15 years in Kenya indicates a significantly high incidence of TBIs and a high mortality rate. This article reviews the available literature as a first step in exploring the status of rehabilitation of Kenyans with cognitive impairments and other disabilities resulting from TBIs. From this preliminary review, it is apparent that despite TBI being a pervasive public health problem in Kenya, it has not received due attention in the public and private sectors as evidenced by a serious lack of post-acute rehabilitation services for people with TBIs. Implications for this lack of services are discussed and recommendations are made for potential approaches to this problem.

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Section: Discussion and Recommendationsmentioning

confidence: 99%

“…In an article published in the Annals of African Surgery, Opondo and Mwangombe (2007) reported that their research was conducted on 87 patients with TBI admitted at KNH Intensive Care Unit (ICU) between April and September, 2005. Fifty-eight percent of the patients were involved in road traffic accidents.…”

Section: Literature Reviewmentioning

confidence: 99%

Traumatic Brain Injury in Kenya

Kinyanjui

2016

Sage Open

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“…1 Although mortality rate following TBI is higher than for the control group of 47.8%, the nature of patients admitted to our ICU varies widely, it being a multidisciplinary unit. Patients in respiratory failure from different causes who require ventilatory support, postoperative patients who require intensive monitoring and care, and stroke patients are among the array of patients managed in the unit.…”

Section: Discussionmentioning

confidence: 99%

“…About 33% of these patients remained in a persistent vegetative state. 1 It has been documented that morbidity and mortality following TBI is determined by the severity and presence of secondary injuries such as hypoxia, hypotension, hypercapnia, hyperglycaemia and acidosis. 2 Teasdale and Jennett 3 described the Glasgow Coma Scale, which was initially designed to assess the level of consciousness after TBI in a neurosurgical intensive care unit.…”

Section: Introductionmentioning

confidence: 99%

Outcome of traumatic brain injury in the intensive care unit: a five-year review

Tobi

Azeez

Agbedia

2016

Southern African Journal of Anaesthesia and Analgesia

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Introduction: Traumatic brain injury (TBI) is a major challenge in the intensive care unit (ICU) with a high mortality. In a recent study, severe TBI accounted for 14.3% of all ICU admissions with a mortality of 54.0%. Methodology: This was a retrospective, case-control study of all cases of TBI admitted into the ICU during the study period. Data retrieved included socio-demographic parameters, causes of TBI, blood transfusion, length of stay and ICU outcome in terms of mortality. Result: One hundred and eighty-two (182) TBI patients were admitted into the ICU, with a mean age of 34 ± 18.92 years. The male:female ratio was 3:1, but females had a better outcome with a p-value of 0.026. Patients who stayed between 1 and 7 days were > 4 times more likely to die in the ICU compared with those who stayed for more than 7 days. In addition, TBI patients who had blood transfusion had a better outcome (p = 0.004). Also, TBI patients who received ventilatory support had higher mortality compared with those who did no, (p = 0.006). Conclusion:Patients with traumatic brain injury admitted to the intensive care unit have a high mortality. A review of the present line of management and strict compliance with guidelines of management may perhaps improve outcome.

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“…In Kenya, 10.3% had good recovery, 8% had moderate disability, 8% had severe disability, 21.8% had persistent vegetative state and 54.0% died. The high mortality rate was related to the high frequency of multiple injuries and late presentation to the hospital (16). While in France, the highest GOS score was moderate disability followed severe disability and lastly good recovery with the global disability remaining high because of lack of rehabilitation center and follow up (15).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Glasgow Outcome Scale score of severe head injury in Mbarara regional referral hospital: A retrospective study

Odwar¹,

Okidi²,

Kayanga³

et al. 2020

Preprint

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Background: Traumatic brain injury (TBI) is a common cause of death in the Intensive care units and emergency departments with an estimated annual global mortality of 1.5 million people as a result of severe TBI. The prevalence of TBI varies according to regions. Despite this, there is limited data on the outcomes of patients following severe traumatic brain injury in southwestern Uganda. Herein, we studied the prevalence and outcome of severe traumatic brain injury at Mbarara Regional Referral Hospital (MRRH) at discharge.Methods: A retrospective chart review of all TBI over six months (August 2016 - February 2017). The primary outcome was the Glasgow Outcome Scale (GOS) score at discharge. A favorable outcome was either good recovery or moderate disability while unfavorable outcome was severe disability, persistent vegetative state or death. Bivariate and multivariate logistic regression analyses were used to determine the factors associated with GOS score at discharge. Data were analyzed using STATA v13.0.Results: A total of 196 hospital records of TBI patients were reviewed, 80 (40.8%) patients had severe TBI, with the average length of hospital stay at 4.3 ± 2.9 days. The mean patients' age was 35 ± 14 years with the most affected age group being 18 - 34 years (58.8%). The GOS score at discharge were; death (42.5%), persistent vegetative state (0%), severe disability (1.3%), moderate disability (3.8%) and good recovery (52.5%). Pupil size and response had a dose-response relationship with unfavorable outcome when both pupils were dilated and non-reactive to light and had a higher odd ratio (OR=6.05) and strongly associated with unfavorable outcome (p=0.011). However, surgery and seizure prophylaxis were significantly associated with favorable outcome (p=0.033), (p=0.016) and a lesser odd ratio (OR=0.29),(OR=0.31) of having unfavorable outcome respectively. Conclusion: Mbarara regional referral hospital, the prevalence of STBI is still high. Both surgery and seizure prophylaxis were associated with favorable outcome at discharge. However, unfavorable outcome was mainly seen amongst patients who develop a complication.

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Outcome of severe traumatic brain injury at a critical care unit: a review of 87 patients

Abstract: OBJECTIVE:To determine the outcome of severe traumatic brain injury and to document the factors influencing mortality.

Cited by 15 publications

References 10 publications

Traumatic Brain Injury in Kenya

Traumatic Brain Injury in Kenya

Outcome of traumatic brain injury in the intensive care unit: a five-year review

Prevalence and Glasgow Outcome Scale score of severe head injury in Mbarara regional referral hospital: A retrospective study

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