TY  - JOUR
PY  - 2017//
TI  - Epidemiology, management, and functional outcomes of traumatic brain injury in sub-Saharan Africa
JO  - World neurosurgery
A1  - Eaton, Jessica
A1  - Hanif, Asma Bilal
A1  - Grudziak, Joanna
A1  - Charles, Anthony
SP  - 650
EP  - 655
VL  - 108
IS  - 
N2  - BACKGROUND: Trauma accounts for 4.7 million deaths each year, with an estimated 90% of these occurring in LMICs. Approximately half of trauma-related deaths are due to central nervous system injury. <br><br>OBJECTIVE: Because a thorough understanding of TBI in LMICs is essential to mitigate TBI-related mortality, we established a clinical and radiographic database to characterize TBI in our low-income setting. <br><br>METHODS: This is a review of prospectively collected data from Kamuzu Central Hospital, a tertiary care center in the capital of Malawi. All patients admitted from October 2016 through May 2017 with a history of head trauma, altered consciousness, and/or radiographic evidence TBI, were included. We performed descriptive statistics, a Cox regression analysis, and a survival analysis. <br><br>RESULTS: 280 patients met inclusion criteria. 80.5% were male, and mean age was 28.8+16.3. Median GCS was 12 (IQR=8-15). Road traffic crashes constituted the most common injury mechanism (60.7%). 148, or 52.3%, of patients received a CT scan, with the most common findings being contusions (26.1%). 88 (33.0%) of patients had severe TBI, defined as a GCS of <8, of whom 27.6% were intubated, while 10.3% received tracheostomies. Overall mortality was 30.9%. Of patients who survived, 80.1% made a good recovery. Female sex was protective, and the only significant predictor of poor functional outcome was presence of severe TBI (HR=2.98, 95% CI=1.79-4.95). <br><br>CONCLUSIONS: TBI represents a significant part of the global neurosurgical burden of disease. Implementation of proven in-hospital interventions for these patients is critical to attenuate TBI-related morbidity and mortality.<br><br>Copyright © 2017. Published by Elsevier Inc.<p />  <p>Language: en</p>
LA  - en
SN  - 1878-8750
UR  - http://dx.doi.org/10.1016/j.wneu.2017.09.084
ID  - ref1
ER  -