Factors contributing to the outcomes in adult patients admitted for traumatic brain injury (TBI) at Kigali University Teaching Hospital.

Abstract

Background: Traumatic Brain Injury (TBI) is one of the major causes of mortality and disabilities worldwide and its burden to the community ranges from severe disabilities imposing long-term rehabilitation, reduced productivity to high mortality rate. Road traffic accident, falls from height, and other assaults even intentional or unintentional, as well as alcohol involvement, have been reported by different studies as the causes of TBI. Nowadays, the number of TBIs are increasing in our country but very few and non-published information are available. Therefore, this study was to identify and describe the factors contributing to outcomes of patients with TBI. Methods: A quantitative, retrospective, and cross-sectional study was conducted on adults patients admitted for TBI at Kigali University Teaching Hospital from 2015 to 2016. A sample of 319 files was selected based on standard TBI inclusion criteria. Data capture sheet have been developed based on different validated clinical models. Using SPSS version 20, collected data were analyzed for frequencies and distribution. Pearson’s Chi2, Fisher exact test, and logistic regression analysis were performed to test for correlation and the P value of 0.05 or less was considered significant. Findings: Findings revealed that age above 60 years old, heart rate above 120 bpm, peripheral oxygen saturation less than 85%, systolic blood pressure less than 75mmHg, Glasgow coma scale 3-5, and bilateral mydriasis were significantly associated with death. Furthermore, Glasgow coma scale less than 9, unilateral myosis, and one reacting pupil were significantly associated with moderate disability, while normal heart rate, peripheral oxygen saturation of 95% and above, mild TBI, normal pupil size and reflexes were significant factors of good recovery outcome. Conclusion and recommendations: The admission profile of TBI patients influence the outcome at discharge. Nurses and other Clinicians may recognize that the admission assessment of TBI patients should be performed with focus and clinical findings may be interpreted well and used to plan for care and predict patient’s outcome at discharge.