Morbidity Audit of 704 Traumatic Brain Injury Cases in a Dedicated South Indian Trauma Center.

BACKGROUND

In the era of evidence-based health care, protocol of intervention in traumatic brain injury (TBI) cases help decide more easily and safely about patients and prevent unnecessary transfer of patients to other centers.

OBJECTIVES

The objective of this study is to provide protocol-based intervention and evaluate the epidemiological, clinical characteristics of TBI cases.

METHODS

This prospective study was conducted on 704 patients who were suspected of TBI at the Department of Neurosurgery, Narayana Medical College and Hospital, followed by protocol-based intervention assessed and reassessed repeatedly.

RESULTS

Overall, TBI involved 569 (80.82%) adults in the productive age groups (21-60 years); among males 81.47%. Among males, highest (23.15%) cases were in the age group of 31-40 years while in females, majority (27.04%) was among 41-50 years. Road traffic accidents were the most common (54.12%) mechanism of injury followed by fall (21.31%) and two-wheelers (15.20%). More than half sustained mild TBI (51.42%) while 26.28% moderate TBI and 22.30% severe TBI; among males, severe TBI victims 102 (18.82%) were in the productive age group. Loss of consciousness was almost a universal and significant observation (95.45%); vomiting was next common finding (76.42%). Bleeding from the ear-nose-throat (ENT) region was more in males (33.58%) than females (20.75%). Glasgow coma scale was significantly related with loss of consciousness (91.08%), vomiting (63.06%), and ENT bleeding (44.59%) in severe, moderate, and mild injuries.

CONCLUSION

A rational clinical acumen with judicious use of diagnostic protocol leads to better management of TBI without unnecessary imaging and thus reduce total health-care costs.