@article{10.11648/j.ajcem.20200804.13,
  author = {Agnes Wabule and Kavuma Arthur Mwanje and Daniel Obua and Janat Tumukunde and Jane Nakibuuka and Samuel Kizito and Peter Kaahwa Agaba and Mary Theresa Nabukenya and Emmanuel Timarwa Ayebale and Arthur Kwizera},
  title = {Burden, Predictors and Short-Term Outcomes of Traumatic Brain Injury Among Patients Admitted to Ugandan Intensive Care Units},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {8},
  number = {4},
  pages = {71-77},
  doi = {10.11648/j.ajcem.20200804.13},
  url = {https://doi.org/10.11648/j.ajcem.20200804.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20200804.13},
  abstract = {Severe Traumatic brain injury (STBI) is a leading cause of morbidity and mortality among young individuals worldwide with worse outcomes being registered in low-income countries. Brain trauma foundation recommends the management of patients with TBI in the intensive care unit (ICU) to prevent secondary brain injury for improved outcome. However, Uganda being a low-income country, still grapples with the availability of ICU resources and space. Information regarding burden, predictors and short-term outcomes of ICU patients with TBI in Uganda has never been reconnoitered. A multicenter prospective observational cohort was conducted between 2013 to 2015 at four Ugandan ICUs. During the study period, we consecutively enrolled 387 critically ill, adult patients with TBI to determine the burden, predictors and short term outcomes in these patients. Baseline demographics, clinical and treatment parameters were recorded and followed till discharge from ICU or death. Of 387 patients enrolled in the study, 277 (71.6%) had moderate TBI, while 113 (29.2%) patients had STBI. The highest burden of TBI was recorded among patients assaulted through mob violence, recorded at 17/21 (81.0%), as shown in table 5. The overall mortality was at 34.4% (95/277) among patients with moderate or severe TBI, and 46.9% (53/113) among patients with STBI alone. Mortality was relatively higher among patients brought by the police, and those brought in at night. Multivariate analysis showed patient intubation, lack of antibiotic use, failure to transfuse, tracheostomy tube not inserted, and being involved in RTA or sustaining a fall were significantly associated with mortality among patients with TBI. We found a high burden of TBI and mortality among ICU patients. Despite limited resources in the local setting, inexpensive and locally available measures can reduce on the length of patient’s stay in the ICU and eventually decrease on the mortality. Improvement in prehospital as well as early trauma and airway care, antibiotic use, blood transfusion plus public health safety measures may reduce on the burden of TBI as well as improve outcomes.},
 year = {2020}
}

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TY  - JOUR
T1  - Burden, Predictors and Short-Term Outcomes of Traumatic Brain Injury Among Patients Admitted to Ugandan Intensive Care Units
AU  - Agnes Wabule
AU  - Kavuma Arthur Mwanje
AU  - Daniel Obua
AU  - Janat Tumukunde
AU  - Jane Nakibuuka
AU  - Samuel Kizito
AU  - Peter Kaahwa Agaba
AU  - Mary Theresa Nabukenya
AU  - Emmanuel Timarwa Ayebale
AU  - Arthur Kwizera
Y1  - 2020/08/13
PY  - 2020
N1  - https://doi.org/10.11648/j.ajcem.20200804.13
DO  - 10.11648/j.ajcem.20200804.13
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 71
EP  - 77
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20200804.13
AB  - Severe Traumatic brain injury (STBI) is a leading cause of morbidity and mortality among young individuals worldwide with worse outcomes being registered in low-income countries. Brain trauma foundation recommends the management of patients with TBI in the intensive care unit (ICU) to prevent secondary brain injury for improved outcome. However, Uganda being a low-income country, still grapples with the availability of ICU resources and space. Information regarding burden, predictors and short-term outcomes of ICU patients with TBI in Uganda has never been reconnoitered. A multicenter prospective observational cohort was conducted between 2013 to 2015 at four Ugandan ICUs. During the study period, we consecutively enrolled 387 critically ill, adult patients with TBI to determine the burden, predictors and short term outcomes in these patients. Baseline demographics, clinical and treatment parameters were recorded and followed till discharge from ICU or death. Of 387 patients enrolled in the study, 277 (71.6%) had moderate TBI, while 113 (29.2%) patients had STBI. The highest burden of TBI was recorded among patients assaulted through mob violence, recorded at 17/21 (81.0%), as shown in table 5. The overall mortality was at 34.4% (95/277) among patients with moderate or severe TBI, and 46.9% (53/113) among patients with STBI alone. Mortality was relatively higher among patients brought by the police, and those brought in at night. Multivariate analysis showed patient intubation, lack of antibiotic use, failure to transfuse, tracheostomy tube not inserted, and being involved in RTA or sustaining a fall were significantly associated with mortality among patients with TBI. We found a high burden of TBI and mortality among ICU patients. Despite limited resources in the local setting, inexpensive and locally available measures can reduce on the length of patient’s stay in the ICU and eventually decrease on the mortality. Improvement in prehospital as well as early trauma and airway care, antibiotic use, blood transfusion plus public health safety measures may reduce on the burden of TBI as well as improve outcomes.
VL  - 8
IS  - 4
ER  - 

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