Pattern, Outcome and Associated Factors of Traumatic Brain Injury at Jimma University Medical Center: A Six Months Cross sectional Study

Abstract

Background-Traumatic brain injury (TBI) is a major cause of mortality and morbidity. According to World Health Organization (WHO) TBI will surpass many diseases as a major cause of death and disability in 2030. It is estimated that TBI affects over 10 million people annually leading to either mortality or hospitalization. Annually more than 4.7million deaths and approximately 40-50 million disabilities occur after injury. The effect of TBI are not limited to an individual’s health but are also a cause of increased socioeconomic burden.So this research can serve as an input in increasing a hospital-based management protocol regarding to the conservative and surgical management of patients diagnosed with TBI. Yet TBI incidence and distribution across regions and socioeconomic divides remain unknown. Objective:To determine pattern outcome and associated factors of traumatic brain injury in Jimma university medical center from July 01/2023 to December 30/ 2023, Jimma Ethiopia. Methodology: Cross-sectional hospital based survey was conducted at JUMC. Patients who were admitted with TBI in the study period and fulfill inclusion criteria was included in the study. Data was collected using structured questionnaire’s, trauma registry and patient chart. Data was collected by Anesthesiology residents, emergency medicine residents,surgery residents and trained nurses. The collected data was entered, clean edited and analyzed using spss version 26.0 statistical software. Result : Among the 310 traumatic brain injury patients, 40.3% were between the age gruop of 18-30 of which most of them were male 267(86.1%) majority of the patients came from jimma zone 184(59.4%), RTA was responsible for 158(51%) of cases, of which 75(47.5%) cases are pedestrician stuck, motor bicycle 105(66.5%) of cases, followed by interpersonal violence(assault) 89(28.7%) of cases & FDA 50(16.1%). Few patients were presented with oxygen saturation of <94% 52(16.8%) among them 12 patients died. About 245(79%) of patients came with mild TBI followed by moderate TBI 44(14.2%) and sever TBI 21(6.8%). Among the brain CT scan finding contusion was the most commom 74(23.9%) followed by DSF 67(21.6%), linear skull # 67(21.6%), EDH 63(20.3%), SDH 38(12.3%), DAI 14(4.5%), SAH 11(3.5%) and BSF # 8(2.6%). Among total cases 23(7.4%) patients was not intubated due to absence of mechanical ventilator at the time. Nity four patients were operated of which 6 patients IX died and the most common operation was hemathoma evacuation 47(15.2%) of cases followed by elevation 26(8.4) & DC 5(1.6%). Only 10 patients were admitted to ICU. Totally, 20(6.5%) of the cases were died of which 10(50%) of them were due to RTA. Multivariate analysis showed that mortality was significantly associated with, older age (AOR: 1.268; 95% CI: 1.029–1.563), GCS 3-8(AOR: 5.311; 95% CI: 2.210–12.760), Manitol usage (AOR: 22.846; 95% CI:4.773–109.341). Conculusion: This study demonstrated that road traffic injury was the commonest cause of traumatic brain injury which affected young age groups. Moreover, high mortality among traumatic TBI patients was strongly associated with older Age, sever TBI(GCS-3-8), and on patients who were managed with manitol.