Outcomes for Traumatic Intracranial Bleeding According to Management for Patients Presenting at University Teaching Hospital-Kigali (UTH-K)

Abstract

Introduction: Traumatic brain injuries (TBIs) remain a leading cause of mortality and disability worldwide, and can lead to debilitating intracranial bleeding. We assessed the impact of early or delayed surgery on the outcomes for patients with traumatic intracranial bleeding. Methods: This was a retrospective chat review study conducted at University Teaching Hospital-Kigali (UTH-K) from August 2015 to July 2016.We reviewed 1657 charts and 89 patients met our study criteria. For patients with traumatic intracranial bleeding, we looked at the type of bleed, surgery or no surgery decided for management, and delay (>24hrs) or no delay (<24hrs) surgery. The primary outcomes were mortality, hospital LOS (days) and disability at discharge. Results: In total, 89 patients were found to have traumatic intracranial bleeding, and among them 41% underwent operative management while 59% had non operative management. The most common intracranial bleed was SDH (46%) in operative group while in non-operative hemorrhagic contusion (63%) was the most common. In the operative group, 81% had early surgery while 19% were delayed. In the operative group, 19% died and 33% had a disability at discharge and the average hospital LOS was 10.6 ± 16.3 days. For the non-operative group, 11.54% died, 41.3% had disability at discharge and the average hospital LOS was 15.7 ± 19.6 days. Conclusion: There was no difference in outcome for patients who underwent operative management compared with those who had non-operative management. Furthermore, for those who had earl surgery compare to delayed surgery but due to small sample size the power to detect the difference is low, so we can conduct a new study with a significant sample size so we can detect the difference