Format

Send to

Choose Destination
J Clin Neurosci. 2018 Jan;47:79-83. doi: 10.1016/j.jocn.2017.10.004. Epub 2017 Oct 20.

Pediatric traumatic brain injury at Mbarara Regional Referral Hospital, Uganda.

Author information

1
Duke University Division of Global Neurosurgery and Neurology, Durham, NC, USA; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
2
Duke University Division of Global Neurosurgery and Neurology, Durham, NC, USA; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
3
Duke University Division of Global Neurosurgery and Neurology, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA; Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.
4
Duke University Division of Global Neurosurgery and Neurology, Durham, NC, USA.
5
Department of Neurosurgery, Mulago National Referral Hospital, Kampala, Uganda.
6
Duke University Division of Global Neurosurgery and Neurology, Durham, NC, USA; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA; Department of Emergency Medicine, Duke University Medical Center, Durham, NC, USA.
7
Duke University Division of Global Neurosurgery and Neurology, Durham, NC, USA; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA. Electronic address: Michael.haglund@duke.edu.
8
Department of Neurosurgery, Mbarara Regional Referral Hospital, Mbarara, Uganda.

Abstract

BACKGROUND:

In Uganda, TBI constitute the majority of neurosurgical admissions and deaths specially in the pediatric population. This study aims to determine the factors associated with poor outcome among pediatric TBI cases at a major referral hospital in western Uganda.

METHODS:

This study was conducted at Mbarara Regional Referral Hospital (MRRH) in western Uganda. All pediatric neurosurgical cases between 2012 and 2015 were reviewed. In-hospital mortality and discharge GCS were the main outcomes of interest. Multivariable logistic regression with backward elimination was used to determine the factors significantly associated with outcome.

RESULTS:

A total of 381 pediatric TBI patients were admitted to MRRH between 2012 and 2015. The mean age was 8.6 (SD 5.6) with a male predominance (62.0%). The most common mechanism of injury overall was RTI, which was responsible for 71% of all TBI cases. In the multivariable logistic regression model, admission GCS < 13 was a strong predictor of poor outcome and in-hospital mortality compared to admission GCS ≥ 13, with patients demonstrating an odds ratio of 30 (95%CI: 7-132) and OR of 18 (95%CI: 4-79), respectively.

CONCLUSION:

Given the lack of published literature on pediatric TBI in LMICs, this study was the first to describe and evaluate risk factors associated with TBI severity among pediatric patients at a major referral hospital in western Uganda. Injury severity on admission was the only variable found to be significantly associated with discharge outcome. This study ultimately highlights the need for more effective preventative measures to decrease admission severity.

PMID:
29066002
DOI:
10.1016/j.jocn.2017.10.004
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center