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

Publication ,  Journal Article
Krebs, E; Gerardo, CJ; Park, LP; Nickenig Vissoci, JR; Byiringiro, JC; Byiringiro, F; Rulisa, S; Thielman, NM; Staton, CA
Published in: World Neurosurg
June 2017

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.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

June 2017

Volume

102

Start / End Page

571 / 582

Location

United States

Related Subject Headings

  • Young Adult
  • Tachycardia
  • Rwanda
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Hypoxia
  • Humans
  • Hospitals, University
  • Hospitals, Teaching
 

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Krebs, E., Gerardo, C. J., Park, L. P., Nickenig Vissoci, J. R., Byiringiro, J. C., Byiringiro, F., … Staton, C. A. (2017). Mortality-Associated Characteristics of Patients with Traumatic Brain Injury at the University Teaching Hospital of Kigali, Rwanda. World Neurosurg, 102, 571–582. https://doi.org/10.1016/j.wneu.2017.03.001
Krebs, Elizabeth, Charles J. Gerardo, Lawrence P. Park, Joao Ricardo Nickenig Vissoci, Jean Claude Byiringiro, Fidele Byiringiro, Stephen Rulisa, Nathan M. Thielman, and Catherine A. Staton. “Mortality-Associated Characteristics of Patients with Traumatic Brain Injury at the University Teaching Hospital of Kigali, Rwanda.World Neurosurg 102 (June 2017): 571–82. https://doi.org/10.1016/j.wneu.2017.03.001.
Krebs E, Gerardo CJ, Park LP, Nickenig Vissoci JR, Byiringiro JC, Byiringiro F, et al. Mortality-Associated Characteristics of Patients with Traumatic Brain Injury at the University Teaching Hospital of Kigali, Rwanda. World Neurosurg. 2017 Jun;102:571–82.
Krebs, Elizabeth, et al. “Mortality-Associated Characteristics of Patients with Traumatic Brain Injury at the University Teaching Hospital of Kigali, Rwanda.World Neurosurg, vol. 102, June 2017, pp. 571–82. Pubmed, doi:10.1016/j.wneu.2017.03.001.
Krebs E, Gerardo CJ, Park LP, Nickenig Vissoci JR, Byiringiro JC, Byiringiro F, Rulisa S, Thielman NM, Staton CA. Mortality-Associated Characteristics of Patients with Traumatic Brain Injury at the University Teaching Hospital of Kigali, Rwanda. World Neurosurg. 2017 Jun;102:571–582.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

June 2017

Volume

102

Start / End Page

571 / 582

Location

United States

Related Subject Headings

  • Young Adult
  • Tachycardia
  • Rwanda
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Hypoxia
  • Humans
  • Hospitals, University
  • Hospitals, Teaching