Factors associated with Outcome in Patients Admitted with Traumatic Brain Injury at the University Teaching Hospital, Lusaka, Zambia

Abstract

Objectives: This study was undertaken to determine the in-hospital outcomes of Traumatic Brain Injury (TBI) patients admitted to the University Teaching Hospital (UTH) Lusaka and their associated factors over a period of one year (December 2012 to November 2013).
Study design: This was a prospective clinical cohort study using convenient sampling method were 211 TBI patients admitted to the UTH Department of Surgery were enrolled at admission to hospital and followed up during their hospital stay until discharged or death.
Methods: A structured questionnaire was used to collect the primary and secondary variables from the patient's hospital record cards to answer the objectives of the study. The end point of the study was the Glasgow Outcome Score (GOS), which was assessed at discharge or death of the patient.
Results: The study showed majority of TBI patients were males at 87.7% while females made up 12.3% only. Brain contusion was the most common radiological finding at 12.3% out of the 89 who had Computed Tomography (CT) scan of the brain done. Mortality was associated with increase in age, abnormal blood pressure of greater than 150/90 mmHg or less than 90/60 mmHg, fixed and dilated pupil/s at the time of admission to UTH and admission to the Main Intensive Care Unit (MICU) and/or a low GCS of below 9/15. The study found a case fatality rate of 25.6%. Among those discharged, 42% had a favourable GOS.
Conclusion: The study showed a case fatality of 25.6%, 6 percentage points lower than an earlier study done at UTH. Although, this finding is still much higher than in developed nations where medical infrastructure is much more developed. Majority of the patients presenting with TBI belong to the productive age group of the society. TBI is still a major contributor to morbidity and mortality like in other study found elsewhere. Most of the discharged TBI patients (42%) went home with a favourable GOS out of the total 73.46% discharged.