A descriptive analysis of traumatic brain injury (TBI) cases seen at a tertiary hospital's trauma unit in South Africa over a one year period
Date
2020-03
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Introduction: Traumatic brain injury (TBI) is a non-degenerative, non-congenital insult to the brain causing temporary or permanent cognitive, physical or neuropsychiatric impairment. This study looked at the prevalence, demographic and annual distribution of TBI at a South African tertiary academic hospital.
Methods: A retrospective, descriptive, cross-sectional study reviewed CT scans and patient folders over a one-year period. Of the 4017 TBI suspected patients, 3829 were eligible for inclusion in the study. From this, a representative sample of 500 patient folders and CT reports were reviewed. Data were analysed with descriptive statistics using Microsoft Excel.
Results: During the study period, 12500 patients were treated in the unit for trauma, 3829 (30.6%) had radiological and/or clinical evidence of TBI (case prevalence of 30.6% and 255.3 per 100,000 study population). The overall male to female ratio was 3.5:1. Almost 60% of patients were between the ages of 21 and 40. TBI showed no seasonal spikes and the commonest cause was assault (n=1999, 52.2%). Mild TBI (399/481, 88.2%) was most prevalent, based on GCS, with 71.2% (356/500) being a Marshall type 1 CT scan finding. Of the patients studied, 85.9% (n=413) were managed using a “pharmaco-observational” approach, 6.7% (n=32) underwent surgery and 5.6% (n=27) were managed in an Intensive Care Unit as a primary intervention. Based on Glasgow Outcome Scale, 36.8% (n=177) of patients were not able to work or attend school at the time of discharge, including 22 (4.6%) patients who died during the study period.
Conclusion: TBI is prevalent public health problem in the Western Cape of South Africa that particularly affects males who are young and in their productive years. Assault is the primary cause. This study showed an endemic pattern that is a constant burden on medical and paramedical institutions. TBI claimed the lives and/or neurocognitive capacity of over a third of those diagnosed.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (MMed)--Stellenbosch University, 2020.
Keywords
Brain -- Wounds and injuries -- South Africa, Brain damage -- South Africa, Neuropsychology -- South Africa, UCTD