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  • Traumatic Brain Injury: The Impact of Dedicated Trauma ICU Management on Outcome

    Final Number:
    1384

    Authors:
    Muhammad Raji Mahmud MD, FACS; Ayodeji Salman Yusuf; ALFIN JENERAL; Samaila Timothy MBBS; Samuel I Gana; Suhayb R. Sanusi; Bello Bala Shehu MD, FRCS, FACS

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: Traumatic brain injury is the most common cause of intensive care unit (ICU) admission worldwide. Most ICU in Nigeria are not trauma dedicated, unlike standard practice in other developed countries of the world. Studies from Lagos, Ilorin and Enugu, all in Nigeria, reported mortality of 77.3%, 70% and 54% respectively in such multispecialty ICU. The objective of this study is to evaluate the effect of dedicated trauma ICU management on the eventual outcome in patient with traumatic brain injury.

    Methods: It is a retrospective review of the medical records of patients admitted into the 8 bedded trauma ICU of National Trauma Centre Abuja from its inception in February 2015 to October 2015. Data on demographic characteristics, mechanism of injury, Glasgow Coma Score (GCS), neuroimaging and interventions were obtained. Outcome in terms of mortality and morbidity was assessed using the Glasgow outcome Score.

    Results: A total of 84 patients were admitted into the trauma ICU within this period. Forty six (55%) of these patients had TBI, 39 (85%) of patients with TBI suffered severe injury and 5 (11) % had moderate TBI. The age range was 3months to 78years, with a median age of 35years. Male to Female ratio was 3:1. Motor vehicular accident was the commonest cause of TBI. The average time interval between injury and presentation is 23.98hrs, while the average time interval between presentation to the emergency and ICU admission is 37 .98hrs. The overall mortality from this study was 48%, with the highest mortality rate seen in severe TBI 20 (87%), and in patients between 31 – 40 years 12 (54.5%).

    Conclusions: Acute TBI is responsible for majority of trauma ICU admissions. Severe TBI still remains the commonest cause of mortality even in dedicated trauma ICU. This study has shown that outcome of TBI care in a dedicated trauma ICU results in better outcome. However better therapeutic and monitoring equipment and further training of medical and nursing staff of the ICU are needed to further improve the overall outcome.

    Patient Care: Having a dedicated trauma ICU will ensure personnel specialization and subsequently a better outcome in TBI.

    Learning Objectives: To know that dedicated trauma ICU contributes significantly to a favourable outcome in Traumatic Brain Injury.

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