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Distribution and characteristics of severe traumatic brain injury at Mulago National Referral Hospital in Uganda.

Publication ,  Journal Article
Tran, TM; Fuller, AT; Kiryabwire, J; Mukasa, J; Muhumuza, M; Ssenyojo, H; Haglund, MM
Published in: World Neurosurg
March 2015

OBJECTIVE: Road traffic accidents are a leading cause of injury in low- and middle-income countries, where mortality rates are disproportionately higher. Patients with severe traumatic brain injury (TBI) tend to have very poor outcomes. To reduce the burden from severe TBI, we describe its distribution at Mulago National Referral Hospital (Kampala, Uganda) and identify the associations between outcomes and patient characteristics, offering insights into prevention and future research efforts to improve clinical care. METHODS: This is a single-institution, retrospective chart review including patients of all ages with a Glasgow Coma Scale (GCS) score of 8 or less (measured upon admission). A database was compiled to maximize all available clinical variables. Descriptive statistics and univariable and multivariable regression models were fitted to identify significant associations with outcome (died or discharged). RESULTS: One hundred twenty patients were identified between July 1, 2008, and June 30, 2009. The cumulative incidence of admissions is 89 per 100,000. Thirty-one patients died in the hospital, yielding a 25.8% mortality rate. Motorcycle road traffic accident was the leading mechanism of injury, and males ages 15-29 years comprised the predominant demographic (42.5% of patients). Initial GCS, change in GCS score during hospital stay, and the presence of hematoma were strongest predictors of outcome. CONCLUSIONS: Severe TBI was a common condition for injury-related hospital admissions at Mulago Hospital. The capacity for neurosurgery may have explained the relatively lower mortality rate than previously reported from Sub-Saharan Africa. Further investigations are needed. Targeted prevention programs focused on motorcycle users and helmet law enforcement should decrease the incidence of severe TBI.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

March 2015

Volume

83

Issue

3

Start / End Page

269 / 277

Location

United States

Related Subject Headings

  • Young Adult
  • Uganda
  • Treatment Outcome
  • Retrospective Studies
  • Prognosis
  • Middle Aged
  • Male
  • Length of Stay
  • Infant, Newborn
  • Infant
 

Citation

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Tran, T. M., Fuller, A. T., Kiryabwire, J., Mukasa, J., Muhumuza, M., Ssenyojo, H., & Haglund, M. M. (2015). Distribution and characteristics of severe traumatic brain injury at Mulago National Referral Hospital in Uganda. World Neurosurg, 83(3), 269–277. https://doi.org/10.1016/j.wneu.2014.12.028
Tran, Tu M., Anthony T. Fuller, Joel Kiryabwire, John Mukasa, Michael Muhumuza, Hussein Ssenyojo, and Michael M. Haglund. “Distribution and characteristics of severe traumatic brain injury at Mulago National Referral Hospital in Uganda.World Neurosurg 83, no. 3 (March 2015): 269–77. https://doi.org/10.1016/j.wneu.2014.12.028.
Tran TM, Fuller AT, Kiryabwire J, Mukasa J, Muhumuza M, Ssenyojo H, et al. Distribution and characteristics of severe traumatic brain injury at Mulago National Referral Hospital in Uganda. World Neurosurg. 2015 Mar;83(3):269–77.
Tran, Tu M., et al. “Distribution and characteristics of severe traumatic brain injury at Mulago National Referral Hospital in Uganda.World Neurosurg, vol. 83, no. 3, Mar. 2015, pp. 269–77. Pubmed, doi:10.1016/j.wneu.2014.12.028.
Tran TM, Fuller AT, Kiryabwire J, Mukasa J, Muhumuza M, Ssenyojo H, Haglund MM. Distribution and characteristics of severe traumatic brain injury at Mulago National Referral Hospital in Uganda. World Neurosurg. 2015 Mar;83(3):269–277.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

March 2015

Volume

83

Issue

3

Start / End Page

269 / 277

Location

United States

Related Subject Headings

  • Young Adult
  • Uganda
  • Treatment Outcome
  • Retrospective Studies
  • Prognosis
  • Middle Aged
  • Male
  • Length of Stay
  • Infant, Newborn
  • Infant