Mortality-Associated Characteristics of Patients with Traumatic Brain Injury at the University Teaching Hospital of Kigali, Rwanda.

Published

Journal Article

OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of death and disability. Patients with TBI in low and middle-income countries have worse outcomes than patients in high-income countries. We evaluated important clinical indicators associated with mortality for patients with TBI at University Teaching Hospital of Kigali, Kigali, Rwanda. METHODS: A prospective consecutive sampling of patients with TBI presenting to University Teaching Hospital of Kigali Accident and Emergency Department was screened for inclusion criteria: reported head trauma, alteration in consciousness, headache, and visible head trauma. Exclusion criteria were age <10 years, >48 hours after injury, and repeat visit. Data were assessed for association with death using logistic regression. Significant variables were included in a multivariate logistic regression model and refined via backward elimination. RESULTS: Between October 7, 2013, and April 6, 2014, 684 patients were enrolled; 14 (2%) were excluded because of incomplete data. Of patients, 81% were male with mean age of 31 years (range, 10-89 years; SD 11.8). Most patients (80%) had mild TBI (Glasgow Coma Scale [GCS] score 13-15); 10% had moderate (GCS score 9-12) and 10% had severe (GCS score 3-8) TBI. Multivariate logistic regression determined that GCS score <13, hypoxia, bradycardia, tachycardia, and age >50 years were significantly associated with death. CONCLUSIONS: GCS score <13, hypoxia, bradycardia, tachycardia, and age >50 years were associated with mortality. These findings inform future research that may guide clinicians in prioritizing care for patients at highest risk of mortality.

Full Text

Duke Authors

Cited Authors

  • Krebs, E; Gerardo, CJ; Park, LP; Nickenig Vissoci, JR; Byiringiro, JC; Byiringiro, F; Rulisa, S; Thielman, NM; Staton, CA

Published Date

  • June 2017

Published In

Volume / Issue

  • 102 /

Start / End Page

  • 571 - 582

PubMed ID

  • 28336445

Pubmed Central ID

  • 28336445

Electronic International Standard Serial Number (EISSN)

  • 1878-8769

Digital Object Identifier (DOI)

  • 10.1016/j.wneu.2017.03.001

Language

  • eng

Conference Location

  • United States