Functional outcomes of patients following emergency neurosurgical interventions for traumatic brain injury performed by general surgeons at rural hospital in Ethiopia

Abstract

Background Traumatic brain injury (TBI) is an important public health problem in Ethiopia and worldwide. TBI can lead to lifelong issues that not only affect the lives of individuals and their families but also have a significant impact on society and the economy, especially where there is poor pre-hospital care, proper intensive care unit and rehabilitation centres. The aim of the study is to assess the functional outcome of patients after neurosurgical intervention following traumatic brain injury performed by general surgeons. Methods This was a single hospital based prospective study on the functional outcomes of patients following neurosurgery at Soddo Chris­tian Hospital (SCH), representing a rural hospital in Ethiopia from January 2015 to January 2017. Outcome was described by using the Extended Glasgow Outcome Score (GOSE). Descriptive statistics and non-parametric methods were used for data analysis. Results Ninety patients underwent neurosurgical intervention. The ages ranged from 2 to 76 years, with a male predominance of 84.4%. Head injury was severe in 23%, moderate in 17% and mild in 60% of patients. Thirty-seven patients had chronic subdural hema­tomas (CSDH), 28 had epidural hematomas (EDH), 18 had depressed skull fractures (DSF), 4 had EDH and DSF, and acute subdural hematoma (ASDH) was seen in 3 patients. Functional outcomes based on GOSE were as follows: 61 (67.8%) had upper good recovery, 15 (16.7%) lower good recovery, 6 (2.2%) upper moderate disability, and 1(1.1%) lower moderate disability score. Overall mortality was 12.2% (n-11). Conclusions Neurosurgical interventions for intracranial haemorrhage and depressed skull fractures can be done safely by general surgeons with good functional outcomes, and acceptable morbidity and mortality rates.