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Abstract
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INTRODUCTION: Trauma is the fifth principal cause of death in Singapore, with traumatic brain injury (TBI) being the leading specific subordinate cause.
METHODS: This study was an 8-year retrospective review of the demographic profiles of adult patients with severe TBI, who were admitted to the neurointensive care unit (NICU) of the National Neuroscience Institute at Tan Tock Seng Hospital, Singapore, between 2004 and 2011.
RESULTS: A total of 780 TBI patients were admitted during the study period; 365 (46.8%) patients sustained severe TBI (i.e. Glasgow Coma Scale score ≤ 8), with the majority being males (75.3%). The ages of the patients with severe TBI ranged from 14 to 93 years, with a bimodal preponderance in young adults (i.e. 21-40 years) and elderly persons (i.e. > 60 years). Motor vehicle accidents (43.0%) and falls (48.0%) were the main mechanisms of injury. Invasive line monitoring was frequently employed. Invasive arterial blood pressure monitoring and central venous pressure monitoring were used in 81.6% and 60.0% of the patients, respectively, and intracranial pressure (ICP) measurement was required in 47.4% of the patients. The use of tiered therapy to control ICP (e.g. sedation, osmotherapy, cerebrospinal fluid drainage, moderate hyperventilation and barbiturate-induced coma) converged with international practices.
CONCLUSION: The high-risk groups for severe TBI were young adults and elderly persons involved in motor vehicle accidents and/or falls. In the NICU, the care of patients with severe TBI requires heavy utilisation of resources. The healthcare burdens of these patients extend beyond the acute critical care phase.
Language: en |