Journal Article

Predictors of poor outcomes in patients with traumatic brain injury at the University Teaching Hospital of Bamenda, Cameroon

Nchufor, Roland, Guea Ngbwa, Ghislain, Anu Fonju, Ronaldo, Djientcheu, Vincent de Paul, Ndome Toto, Orlane, Haman, Nassourou Oumarou

2025

Overview

This study aimed to determine the various predictors associated to poor outcomes in patients with traumatic brain injury at the University Teaching Hospital of Bamenda, Cameroon. This descriptive and observational study was conducted at the University Teaching Hospital of Bamenda, Cameroon from February 1st 2023 to May 31st 2023. We included all patients managed for TBI in the named hospital within the study period who gave their consent. A prospective inclusion of data was done using a pre-established technical form aimed at collecting sociodemographic information, mechanism of TBI, clinical/paraclinical parameters and Glasgow Outcome Score (GOS) at one month follow-up. Patients with GOS 1, 2, 3 and 4 were considered as having a poor outcome and good outcome for GOS 5. Data collected were entered and analysed using the SPSS statistical software version 25.0. We found 93 patients who were eligible as per selection criteria. Mean age at presentation was 34.8 ± 15.0 years and there was a male preponderance (87.1 %). Road traffic accident (72 %) was the most common cause of injury followed by assault (14 %) and falls (9.9 %). The overall mortality was 16.1 % and 76.3 % had a good recovery at one month. Poor outcome (GOS<4 at one month) on univariate analysis was associated with delay to treatment > 1 day (p = 0.007, OR = 4.603), GCS less than or equal to 8 (p = 0.000, OR = 3.948), pupillary abnormalities (p = 0.000, OR = 21.630), secondary LOC (p = 0.026, OR = 8.538), intracerebral hematoma (p = 0.036, OR = 3.600), use of diuretics (p = 0.000, OR = 12.143), oxygen saturation less than 90 % (p = 0.026, OR = 5.538) and use of oxygen (p = 0.001, OR = 9.940) in patients with TBI. However, on multivariate analysis, only the GCS (p = 0.044, OR = 12.152) and delay to treatment (p = 0.024, OR = 18.349) retained statistical significance as independent predictors of poor outcomes. Our study suggests that numerous clinical/paraclinical factors such as GCS and patient-related factors like delay in seeking medical care negatively impact outcomes in TBI. This stress the need to carry out adequate clinical evaluation and good therapeutic care by physicians as well as population sensitization in order to reduce the mortality and morbidity related to TBI. Further prospective studies on larger sample size and a longer study period on outcome evaluation are warranted to provide more statistical power to our observations. •Traumatic brain injury is mostly seen in young male patients.•The Glasgow Coma scale and the Glasgow outcomes scale are used to assess the TBI severity and outcomes.•Low Glasgow Coma Scale and delayed treatment are associated to poor outcomes.

• Publisher: Elsevier B.V,Elsevier Limited
• Subject: Accidents, Traffic / Adolescent / Adult / Blood pressure / Brain Injuries, Traumatic - diagnosis / Brain Injuries, Traumatic - epidemiology / Brain Injuries, Traumatic - mortality / Brain Injuries, Traumatic - therapy / Cameroon - epidemiology / Disability / Diuretics / Female / Females / Glasgow Outcome Scale / Hematoma / Hospitals, Teaching / Hospitals, University / Humans / Male / Middle Aged / Morbidity / Mortality / Multivariate analysis / Neurology / Neurosurgery / Patients / Poor outcomes / Predictors / Prognosis / Prospective Studies / Regression analysis / Statistics / Teaching hospitals / Traumatic brain injury / Treatment Outcome / Young Adult