Outcome at two weeks in patients with Traumatic brain injury following road traffic accidents in an urban tertiary hospital in Uganda

Abstract

: Road traffic accidents (RTAs) are a major global public health problem and are now a recognized neglected pandemic. Head injuries cause immediate death in 25% of acute trauma. We conducted this study to determine the immediate outcomes in adult with head injury following RTA. A prospective study was conducted among 178 adult patients and followed up for two weeks to determine immediate outcomes. Multivariate logistic regression analysis was used to determine predictor variables of immediate outcome. Majority had moderate disability (38.2%), then severe disability (25.8%) and good recovery (24.7%) at two weeks. Persistent vegetative state and death occurred in 2 and 9% of patients respectively. Sixty-three percent of patients had favourable outcome. Convulsions, intracerebral haemorrhage had significant p-values at bivariate analysis (0.019, 0.008 respectively) at GCS. Vomiting, convulsions, extra cerebral haemorrhage and intracerebral haemorrhage had significant association p values (0.000, 0.001, 0.000 and 0.000 respectively) at two weeks by GOS. Level of consciousness (p-value = 0.000), intracerebral haemorrhage (p = 0.003), skull fractures (p = 0.001) and surgery (p = 0.016) were statistically significant at multivariate analysis. GCS and GOS were important in assessment of immediate outcomes at 2 weeks but GOS was a more reliable assessment tool.