Factors affecting mortality in severe traumatic brain injury in adults at a teaching hospital in Dakar
Objective: To assess factors contributing to mortality of adult patients admitted to intensive care units for severe traumatic brain injury (TBI).
Patients and methods: This is a retrospective, descriptive and analytical study. Included in the study were all adults patients admitted for severe TBI. From the hospital records, socio-demographic, clinical, and paraclinical data was collected. Data on handling by the intensive care unit and the complications that occurred during this period were also collected. The Epi-data software was used to enter the data and the Epi-info software for the data analysis. The Chi 2 test and Fisher exact test were used for data analysis for probability testing where appropriate. A p-value < 0,05 was considered as statistically significant.
Results: Over the period of the study, 124 severe TBI were admitted in the neurological resuscitation unit of the Dakar Fann Teaching Hospital, representing 39.2% of all TBI. The average age of the patients was 41.6 years [15-74 years]. The Glasgow score was between 7 and 8 for 74 patients (60.3%) and between 3 and 6 for 50 patients (39.7%). Mortality rate was at 63.2%. Age ≥” 60 years, low blood pressure, hypoxaemia, and hypernatremia were the factors associated with an increased mortality.
Conclusion: Prognosis for severe TBI is narrowly tied to the occurrence of secondary brain attack factors from a systemic origin. Their early prevention and handling should be a primary concern for resuscitation specialists.
Keywords: Severe TBI, Secondary brain attacks of systemic origin, Factors affecting Mortality