The Clinical Outcomes of Patients with Head Injuries at a Resource-Limited Secondary-Level Hospital in Eastern Province, Zambia

Abstract

Background

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide. TBI disproportionately affects low- and middle-income countries (LMICs). Evidence describing the clinical outcomes of head injuries in rural Zambia remains limited. The objective of this study is to describe the epidemiology and clinical outcomes of patients with head injuries treated at a secondary-level referral hospital in Eastern Province, Zambia.

Methods

We conducted a retrospective cohort study of patients treated for head injuries at St. Francis Mission Hospital between 2019 and 2021. Data on demographics, injury characteristics, diagnostic investigations, management, and outcomes were extracted from hospital records.

Results

A total of 567 patients with head injuries was included. The mean age was 29.4 years and 88.5% (502/567) were male. Road traffic accidents accounted for 60.0% (340/567) of injuries, with motorcycles 41.2% (140/340) and bicycles 22.4% (76/340) contributing most. The majority of patients presented with mild TBI (88.9% [504/567]), while 5.3% (30/567) had moderate TBI, and 5.8% (33/567) had severe TBI. Computed tomography (CT) imaging was performed in 6.2% (35/567) of patients. A total of 13.8% (78/567) underwent surgical management. A total of 3.7% (21/567) required intensive care unit (ICU) admission, of which 61.9% (13/21) died. The overall mortality rate was 4.1% (23/567).

Conclusions

Head injuries in Eastern Zambia predominantly affect male motorcycle and bicycle road users within the working-age population. Although overall mortality was only 4.1%, mortality among patients requiring ICU care was 61.9%. Strengthening neurocritical care capacity and supporting task-sharing initiatives between general surgeons and neurosurgical teams may improve outcomes in resource-limited settings.