Citation

Takoukam R, Kanmounye US, Robertson FC, Zimmerman K, Nguembu S, Lartigue JW, Park KB, Figuim B, Esene I. World Neurosurg. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.wneu.2020.06.182

PMID

32599210

Abstract

INTRODUCTION: Traumatic brain injury (TBI) is the most common neurosurgical condition globally. In Cameroon, there are 572 cases of TBI per 100,000 people, but less than 40% of Cameroonians live within 4 hours of a neurosurgical facility. The authors sought to understand the clinical outcomes at a neurosurgical center in Central Cameroon.

MATERIAL AND METHODS: This cross-sectional study was conducted at the largest neurosurgical center of Cameroon, the Yaounde Central Hospital. Data included 100 consecutive patients undergoing an intervention 72 hours following their injury from February 1st, 2015 to February 1st, 2019. Patients with missing data or undergoing surgery >72 hours post-injury were excluded. Analyses of covariance were run, and a P-value >0.05 was considered significant. A Kaplan-Meier survival curve was computed.

RESULTS: The patients had a mean age of 31.3 ± 17.4 years, with a male predominance of 91.0%, and the principal mechanism of injury was road traffic accidents (68.0%). Only 11% arrived via ambulance, and 36.0% were admitted less than 3 hours after the traumatic event. The postoperative mortality rate was 15.0%, mean survival time was 25.0 postoperative days (95% CI: 23.42-26.52), and the mean Glasgow outcome scale at 28 days was 3.9 ± 1.4.

CONCLUSION: The majority of TBI patients undergoing neurosurgery 72 hours post-injury in Cameroon arrive at the hospital late and have a high mortality risk during the first postoperative week. Investments in prehospital care should be made to improve surgical outcomes.

Language: en

Keywords

Traumatic brain injury; Cameroon; Craniectomy; Cranioplasty; Craniotomy; Global neurosurgery; Neurosurgery; Neurotrauma