Outcomes of severe traumatic brain injury at time of discharge from tertiary academic hospitals in Bloemfontein
Despite being a major public health concern, limited data are available regarding survival rates and the requirement for post-hospitalisation support of patients with traumatic brain injury (TBI) in South Africa.
To describe the clinical profile and in-hospital outcome of patients with TBI at intensive care units (ICUs) of tertiary referral hospitals in the Free State Province, South Africa, between 2013 and 2017, and determine the need for further rehabilitation at the time of discharge from hospital.
This retrospective descriptive study of patients with TBI was conducted at Pelonomi Tertiary and Universitas Academic Hospitals. Patients' demographic information and variables such as mechanism and type of injury, Glasgow Coma Scale (GCS) prior to ICU admission, neurosurgical intervention, duration of stay in ICU and hospital, GCS and final outcome at discharge, were recorded.
The 138 patients included in the final data analysis had a median age of 30.5 years (range 13–70 years), with a male predominance of 82.6%. The median length of stay in ICU and hospital were 6 and 16 days, respectively. Outcomes data showed that 65.9% of patients survived until discharge from hospital. Of patients whose Glasgow Outcome Scale (GOS) could be determined at discharge, 52.8% were deceased, 7.9% were in a persistently vegetative state, 11.2% had severe and 13.5% moderate disability, and 14.6% had a good recovery.
Traumatic brain injury is associated with high mortality and morbidity. The lack of post-hospitalisation rehabilitation and support of patients and their caregivers require urgent redress.
Shaun Donnovin Maasdorp, University of the Free State
Carla Swanepoel, Pelonomi Tertiary Hospital
Louisa Gunter, Pelonomi Tertiary Hospital
Guy Richards, University of Witwatersrand
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Date published: 2020-06-15
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African Journal of Thoracic and Critical Care Medicine| Online ISSN: 2617-0205
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