Emerging Challenges in the Management of Initial Traumatic Brain Injury: A Prospective Study from a Developing Country

Abstract

Objective:  To identify and highlight the challenges faced in initial traumatic brain injury management in a developing country Materials and Methods:  The study includes 294 TBI-related admissions. We included all admitted Patients with Traumatic brain injury via. A and E (accident & emergency) departments and all patients of either age or gender. We included information related to the area of the initial trauma, whether the patient was referred from another setup after initial management, whether CT brain was performed at an initial health care facility, time since trauma to our hospital/ER presentation, duration of stay in our hospital, whether ICU was provided or not, and whether the patient was managed conservatively or required surgery at our hospital. Results:  Out of the total patients received male to female ratio was 9 to 1 and the age group most involved was 15 to 45 years old.72% of patients were referred from local healthcare setups. 24% of patients underwent surgery. 64% were received from other districts. CT was performed by 41% before presenting. 61% of patients reached the hospital within 3 hours of injury. 51% stayed in the hospital for 1 – 3 days. 17% were shifted to ICU, Ventilator support was only given to 9.5% of patients. In 25% of patients, Steroids were given, and 5 redo surgeries were performed in the same hospital setting. Conclusion:  This Short report provides a snapshot of the difficulties and weaknesses of the health system in the region.