A prospective neurosurgical registry evaluating the clinical care of traumatic brain injury patients presenting to Mulago National Referral Hospital in Uganda

PloS One
Benjamin J KuoMichael M Haglund

Abstract

Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to Mulago National Referral Hospital (MNRH), Kampala, Uganda. We used a prospective neurosurgical registry based on Research Electronic Data Capture (REDCap) to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. 563 TBI patients were enrolled from 1 June- 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ...Continue Reading

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Citations

Nov 30, 2018·Journal of Neurosurgery. Pediatrics·Silvia D VacaGerald Grant
Oct 2, 2019·Journal of Neurosurgery·Michael M Haglund, Anthony T Fuller
Mar 23, 2019·Trauma Surgery & Acute Care Open·Nukhba ZiaAdnan A Hyder
Apr 3, 2020·International Journal of Environmental Research and Public Health·Silvia D VacaGerald Grant
Mar 20, 2021·Risk Management and Healthcare Policy·Eka BurkadzeCorinne Peek-Asa
May 11, 2019·Journal of Neurosurgery·Thiago Augusto Hernandes RochaJoao Ricardo Nickenig Vissoci

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Software Mentioned

Stata
Research Electronic Data Capture ( REDCap )
REDCap

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.