Head injury triage in a sub Saharan African urban population

Qureshi, Javeria S.; Ohm, Rebecka; Rajala, Henrik; Mabedi, Charles; Sadr–Azodi, Omid; Andrén‐Sandberg, Åke; Charles, Anthony

doi:10.1016/j.ijsu.2013.01.011

Cited by 42 publications

(36 citation statements)

References 25 publications

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“…GCS was developed to categorise head injury in the 1970 s and still is widely used in over 80 countries for prognosis and research [5] . A recent study in Malawi confirmed the usefulness of GCS as a mortality marker in a resource limited setting [16] . Amongst PMH EC HI patients who had a GCS recorded; 6% were severe, 10% moderate and the remainder mild.…”

Section: Discussionmentioning

confidence: 87%

Head injury burden in a major referral hospital emergency centre in Botswana

Cox

Becker

Motsumi

2018

African Journal of Emergency Medicine

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IntroductionThis study describes the demographics, aetiology, emergency centre diagnosis and severity indicators of patients with head injuries presenting to the largest referral hospital emergency centre in Botswana.MethodsCross-sectional retrospective data was collected from July 2015 to September 2015 for all emergency centre head injury presentations at Princess Marina Hospital. Information was extracted from emergency centre records regarding patient demographics, mechanism of injury, clinical observations, diagnosis, and treatment.ResultsThree-hundred and sixty head injury patients presented to the emergency centre in the three months, averaging four per day. 80% were less than 40 years of age and males accounted for 69% of all presentations. 58% of injuries were listed as being accidental, 39% recorded from assaults and 38% from road traffic accidents. The most common emergency centre clinical diagnosis was concussion and the most common radiological diagnosis skull fracture. The median Glasgow Coma Scale was 15 with a range from 3 to 15; and, among patients for whom Revised Trauma Score could be calculated, 79% scored the lowest probability of death in the Revised Trauma Score.DiscussionHead injury disproportionately overburdened males in this study, and head injury aetiology and demographic picture was similar to regional data. Severity scoring using the Glasgow Coma Scale was only available among 66% of patients and Revised Trauma Score calculable in half of presentations. Only 55% of head injury patients were discharged from the emergency centre, despite the preponderance of low severity scores. Head CTs appear to have been over-utilised and implementation of a Traumatic Head CT guideline for our setting is proposed. This study improves understanding of the burden of head injury in Botswana and advocates for national referral guidelines for patients with head injury in Botswana.

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Section: Discussionmentioning

confidence: 87%

Head injury burden in a major referral hospital emergency centre in Botswana

Cox

Becker

Motsumi

2018

African Journal of Emergency Medicine

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“…[ 3 ] In sub-Saharan Africa, there is a paucity of accurate trauma data on the contribution of head injury to trauma-related mortality. [ 4 ] However, sub-Saharan Africa demonstrates a higher head injury-related rate varying from 150 to 170/100,000, respectively, due to motor vehicle crashes compared to a global rate of 106/100,000. [ 5 ] A cross-sectional hospital-based study in Nigeria reported that 31% of all trauma deaths were attributable to severe head injury.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography pattern of traumatic head injury in Niger Delta, Nigeria: A multicenter evaluation

Onwuchekwa

Alazigha

2017

Int J Crit Illn Inj Sci

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Background and Purpose:Traumatic head injury has a high mortality and morbidity in low- and middle-income countries. Brain injury following trauma is the cause of death in about one-third of patients that die after trauma. The aim of the study was to assess the pattern of computed tomography (CT) findings in head trauma at the tertiary health institutions serving the Niger Delta region of Nigeria.Patients and Methods:The CT scans of the head of 310 consecutive patients referred specifically for evaluation of head injury were prospectively reviewed. The images acquired were analyzed by the radiologists. The radiological features and anatomical distribution of the lesions on the CT Images were assessed and documented. Patients with congenital abnormalities of the head and those whose fall or injury were secondary to stroke were excluded from the study. The Ethical Committee of our institutions gave approval for the study.Results:There were 225 (72.58%) males and 85 (27.42%) females. About 44.84% of the patients were in the third and fourth decades of life. The major causes of head injury were road traffic accidents in 67.74%, falls in 14.84%, and assaults in 7.42%. Most of the patients 102 (33.0%) presented within the 1st week of injury. Cranial fractures were found in 87 (28.06%) patients. In this series, 111 (35.81%) had normal CT findings while 199 (64.19%) had abnormal CT findings. Intra-axial lesions were the most common, constituting 131 (42.26%) cases.Conclusion:This study had demonstrated that majority of head trauma evaluated by CT were associated with cranial and brain injuries. Intra-axial injuries are more prevalent. Poor health facilities and bad road networks in addition to being risk factors for head injury also hamper the management of head-injured patients as shown by the long duration of injury before health facilities are accessed.

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“…Pre-hospital care Care details included first aid and pre-hospital assessment, transport time, mode of arrival [ 25 , 29 , 37 , 39 , 40 ] 3. Injury event information Date and time of injury, place and activity of injury [ 4 , 23 – 26 , 28 – 43 ] 4. Emergency room assessment and treatment Vital signs, GCS, pre-existing conditions, suspicion of alcohol and substance use, lab and radiology investigations, patient management, respiratory support, ED disposition [ 4 , 23 , 25 – 37 , 39 , 41 ] 5.…”

Section: Main Textmentioning

confidence: 99%

Traumatic brain injury in Uganda: exploring the use of a hospital based registry for measuring burden and outcomes

et al. 2018

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ObjectiveLack of data on traumatic brain injuries (TBI) hinders the appreciation of the true magnitude of the TBI burden. This paper describes a scientific approach for hospital based systematic data collection in a low-income country. The registry is based on the evaluation framework for injury surveillance systems which comprises a four-step approach: (1) identifying characteristics that assess a surveillance system, (2) review of the identified variables based on adopted specific, measurable, assignable, realistic, and time-related criteria, (3) assessment of the proposed variables and system characteristics by an expert panel, and (4) development and application of a rating system.ResultsThe electronic hospital-based TBI registry is designed through a collaborative approach to capture comprehensive, yet context specific, information on each TBI case, from the time of injury until death or discharge from the hospital. It includes patients’ demographics, pre-hospital and hospital assessment and care, TBI causes, injury severity, and patient outcomes. The registry in Uganda will open the opportunity to replicate the process in other similar context and contribute to a better understanding of TBI in these settings, and feed into the global agenda of reducing deaths and disabilities from TBI in low-and middle-income countries.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3419-1) contains supplementary material, which is available to authorized users.

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Head injury triage in a sub Saharan African urban population

Cited by 42 publications

References 25 publications

Head injury burden in a major referral hospital emergency centre in Botswana

Head injury burden in a major referral hospital emergency centre in Botswana

Computed tomography pattern of traumatic head injury in Niger Delta, Nigeria: A multicenter evaluation

Traumatic brain injury in Uganda: exploring the use of a hospital based registry for measuring burden and outcomes

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