Retrospective study of traumatic brain injury cases

Abstract

Objectives: The global annual incidence of traumatic brain injury (TBI) is predicted to reach 69 million cases. The World Health Organization indicates that about 10 million annual cases of TBI result in death or significant disability. The incidence of morbidity and mortality due to TBI is higher in low and middle-income nations, particularly in sub-Saharan Africa, where mortality rates can be up to threefold greater than in high-income countries. There are limited studies on TBI management. This study aimed to shed light on the status of TBI care in a referral facility in Kenya. The objective of this study was to describe the socio-demographic and clinical profiles of TBI patients treated at the Presbyterian Church of East Africa (PCEA) Kikuyu Hospital in Kenya. Materials and Methods: This was a retrospective cross-sectional study conducted at PCEA Kikuyu Hospital. We reviewed the records of patients with TBI treated at the hospital between January 2018 and December 2023. The study population included all admitted patients of all ages who sustained a traumatic injury within the study period, based on hospital patient records and the trauma registry. Results: A total of 503 records of patients with TBI who visited the hospital between January 2018 and December 2023 were included. The mean age was 29.8, with a standard deviation of 14.7. There were 411 (81.7%) males and 92 (18.3%) females. Most cases of TBI resulted from road traffic accidents (RTAs). The symptoms of raised intracranial pressure (ICP) were present in 72.6% of the cases, while basal skull fracture symptoms were present in less than a quarter of the cases. About 10% of the patients had severe TBI. About a third of the head computed tomography findings reported intracranial hemorrhages. Most patients were managed conservatively, and three patients died at the hospital. ICP symptoms and basal skull fractures showed highly significant associations with severe TBI. Conclusion: Most TBI patients were predominantly young and of the male gender. RTAs remain the leading cause of TBI, underscoring the continued public health burden of road-related trauma. A high proportion of patients exhibited symptoms of raised ICP, while basal skull fracture signs were less common. Most patients were managed conservatively, reflecting both the clinical challenges and the resource constraints faced in TBI care within low- and middle-income settings.