Management of Traumatic Brain Injury at a Medium Complexity Hospital in a Remote Area of Amazonas, 2017-2019

World Neurosurg. 2021 Apr:148:e151-e154. doi: 10.1016/j.wneu.2020.12.088. Epub 2020 Dec 26.

Abstract

Objective: To describe the traumatic brain injury (TBI) care in the city of Coari, Amazonas, from 2017-2019.

Methods: Ecological study based on the analysis of the data obtained by the Epidemiology Service of the Regional Hospital of Coari regarding TBI attendances in the emergency room from January 2017 to October 2019. According to the Glasgow Coma Scale, TBI was classified as mild, moderate, or severe. Other variables analyzed were sex, age, main causes of TBI, hospitalizations at the admission unit, and transfers to another health center and means of transport used.

Results: One hundred ten admissions were registered: 24 mild TBI, 51 moderate, and 35 severe; higher prevalence among men (70%); and age between 20 and 29 years (29%). The main causes were motorcycle accidents (42.7%), falls (29%), and physical aggression (21%). Some 69% of the patients admitted required to be transferred to another health center, with aerial intensive care unit (ICU) as the most significant means of transport (48.7%). Thirty patients hospitalized at the admission unit progressed with hospital discharge and 4 died.

Conclusions: The profile of patients affected by TBI in the city of Coari was characterized by male victims of motorcycle accidents with age between 20 and 29 years. The high transfer rates indicates the need for a better neurotrauma assistance. Further investigations and studies associated with regional specificities are essential to recommend changes on the scope of public health and therefore decrease the incidence of TBI.

Keywords: Epidemiology; Public health; Traumatic brain injury.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Injuries, Traumatic / diagnosis
  • Brain Injuries, Traumatic / epidemiology*
  • Brain Injuries, Traumatic / therapy*
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Disease Management*
  • Emergency Service, Hospital / trends*
  • Female
  • Hospitalization / trends
  • Hospitals, Rural / supply & distribution
  • Hospitals, Rural / trends*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Young Adult