scholarly journals Registry-based pilot epidemiological study of traumatic brain injury in a tertiary trauma care center in Kerala, India – Difficulties encountered during data collection warranting the need for standardized electronic database

2021 ◽  
Vol 12 ◽  
pp. 414
Author(s):  
Vinu V. Gopal
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pilot Study ◽  
Head Injury ◽  
Data Collection ◽  
Care Center ◽  
Tertiary Care ◽  
Developed Countries ◽  
Electronic Database ◽  
Traumatic Head Injury

Background: Head injury is referred to as a “silent epidemic” globally. Studies regarding epidemiology of head injury are very few especially in Kerala and most have conflicting reports. Unlike developed countries, there is no well-established system for collecting and managing information on traumatic brain injury (TBI) in India, especially in Kerala. The present study shares the difficulties encountered and the insights acquired by conducting a registry-based epidemiological pilot study for collecting a baseline data of traumatic head injury patients in a tertiary care center in Kerala. Methods: The pilot study was conducted to know the efficiency of present reporting system of a tertiary hospital in Kerala. We tried to collect retrospective data from December 2018 to December 2019 in the department of neurosurgery. As there was no standardized protocol or electronic database for data collection in hospital, we made a sample proforma for data collection. The patient details were obtained from medical records (case sheets), resident doctor’s, and staff nurse’s notes which included demography, clinical details, and radiological findings which were analyzed. Results: We were not able to fill the full details regarding demography, prehospital data, and clinicoetiological details which are important as far as head injury management is considered. The hospital records were grossly inadequate for full retrieval of information. Inadequate case definition and lack of centralized electronic reporting mechanisms were some of the major difficulties we faced obviating the need for collecting, managing, and utilizing epidemiological data using an electronic database. Conclusion: We believe that the present pilot study will give an insight regarding the difficulties encountered in collecting data regarding TBI. This study will be the first of its kind in Kerala highlighting the importance of maintaining a proper head injury electronic registry. The data from this study would definitely guide future experimental operational research on these unexplored areas which will be relevant in head injury policy-making in Kerala as well as in India.

Long Term Symptoms and Limitations of Activity of People with Traumatic Brain Injury: A Ten-Year Follow-up

2005 ◽  
Vol 97 (1) ◽  
pp. 169-179 ◽  
Author(s):  
C. O'Connor ◽  
A. Colantonio ◽  
H. Polatajko
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Care Center ◽  
Tertiary Care ◽  
Consecutive Series ◽  
Post Injury ◽  
What Is Said

This study examined the effect of Traumatic Brain Injury 10 years post-injury. Frequencies of head injury symptoms and activity limitation by level of severity were measured in a consecutive series of 61 adults who were admitted to a tertiary-care center for traumatic brain injury. Irritability and Anxiety were the most frequently reported symptoms from the Head Injury Symptom Checklist. Bothered by noise and Bothered by light were the least frequently reported. Trouble hearing what is said in a group conversation and Trouble hearing what is said in a one-to-one conversation were the most commonly reported limitations of activity from the Health and Activity Limitations Survey. Overall, this study illustrates that symptoms remain many years following brain injury, irrespective of the injury's severity.

scholarly journals An Epidemiological Study of Traumatic Head Injury in a Tertiary Care Center in Kancheepuram, Tamil Nadu, India

2019 ◽  
pp. 1-5
Author(s):  
K. Myl Kumaran ◽  
Pragadeesh Raja ◽  
M. Jasmine
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Tamil Nadu ◽  
Road Traffic ◽  
Tertiary Care ◽  
Major Public Health Problem ◽  
Traumatic Head Injury ◽  
History Of ◽  
Traumatic Head

Introduction: Traumatic brain injury is a major public health problem in India. The severity of a traumatic brain injury may range from mild to severe. The increase in economic growth in India coupled with rise in population, motorization and industrialization has contributed to a significant increase in TBI with each advancing year. India having the highest rate of head injury in the world. In India more than 100000 lives are lost every year with over 1 million suffering from serious head injury. Objectives: To assess the risk factors among for head injury cases and assess the outcome of the traumatic brain injury patients. Materials and Methods: A cross sectional Study conducted among all patients with traumatic head injury attending tertiary care centre and those admitted in intensive care unit with the history of traumatic head injury for the duration of one year (August 2016 to July 2017). Data was collected through questionnaire, hospital records and collected from patients. Data Collected was entered in MS office excel and analyzed in SPSS version 21. Results: Totally 295 cases were reported with history of traumatic brain injury, out of which 82.7% were males and 17.3% were females. Road traffic accidents was the most common cause for TBI 86.4%. Most of the patient was between the age group of 21-40 (51.5%). Most of the cases were from rural areas 55.3%. Based on GCS 49.5%, 28.5% and 22.0% patients had mild, moderate and severe injury respectively. 44.7% injuries occurred between the time period 04.00PM to 12.00AM. Conclusion: This study revealed that most traumatic head injury occur due to Road traffic accident stressing the urgent need to create awareness and conduct health education about prevention of traumatic head injury.

scholarly journals Acute and Chronic Posterior Pituitary Insufficiency Among Traumatic Brain Injury Patients at a Tertiary Care Center

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A623-A623
Author(s):  
Imtiyaz Ahmad Bhat ◽  
Moomin Hussain Bhat ◽  
Shariq Rashid Masoodi ◽  
Javid Ahmad Bhat ◽  
Zafar A Shah ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Diabetes Insipidus ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Posterior Pituitary ◽  
Urinary Osmolality ◽  
Pituitary Dysfunction

Abstract Background: Traumatic brain injury (TBI) is the leading cause of death and disability in young adults. Disorders of salt and water balance are the most commonly recognized medical complications in the immediate post-TBI period and contribute to early morbidity and mortality. Objective: We aimed to evaluate the prevalence of acute (during hospital stay) and chronic posterior pituitary dysfunction in patients of head injury admitted at our tertiary care hospital. Study Design: Prospective, Observational study. Participants: 136 patients, attending tertiary care in North India with TBI with radiological evidence of head injury. Methodology: The severity of brain injury was assessed by the Glasgow Coma Scale (GCS), and Modified Rankin Scale (MRS) score at the time of admission. Lab measurements, apart from routine CBC and biochemical tests, included tests of serum and urinary osmolality, serum sodium, cortisol, and thyroid function test during the hospital stay. All patients were monitored closely during the hospital stay. Surviving patients were evaluated at 3, 6, and 12 months of follow-up. Urinary output and water deprivation tests were done to determine chronic posterior pituitary dysfunction. The results were compared against normative data obtained from 25 matched, healthy controls. Serum & urinary osmolality was measure by the freezing point method. Diabetes insipidus (DI) and Syndrome of inappropriate ADH secretion (SIADH) were diagnosed according to standard criteria. Results: Of 136 patients admitted, 61 (44.85%) had a mild head injury (GCS, ≤8), 47 (35.55%) had a moderate injury (GCS, 9-12), and 27 (19.85%) had a severe injury (GCS, 13-15). DI occurred in 10 patients (7.4%), while SIADH was observed in 4 patients in the immediate TBI period. Risk factors for diabetes insipidus were GCS of ≤ 8 at admission, midline shift, and surgical intervention. DI was an independent risk factor for death. There was a negative correlation between the presence of DI and GCS score (r, -0.367). Most of the patients with DI (8 out of 10) died during the hospital stay. One patient persisted to have partial diabetes insipidus and another one SIADH at three months post-TBI; both patients had recovered at six months of follow-up. No new case of DI or SIADH occurred on the follow up to 12 months. Conclusion: The incidence of acute DI in severe head injury (GCS ≤ 8) could be an indicator of the severity of TBI, and associated with increased mortality as most of our patients died during the hospital stay.

scholarly journals Admission characteristics and outcome in traumatic brain injury patients: a preliminary report from a tertiary care hospital

2016 ◽  
Vol 30 (2) ◽  
pp. 252-257
Author(s):  
Amit Agrawal ◽  
Ashok Munivenkatappa ◽  
B.V. Subrahmanyam ◽  
S. Satish Kumar ◽  
P. Ramamohan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pilot Study ◽  
Developing Country ◽  
Rural Areas ◽  
Tertiary Care ◽  
Study Finding ◽  
Care Hospital ◽  
Intracranial Surgery ◽  
Present Pilot Study

Abstract Introduction. Traumatic brain injury (TBI) is affected by multiple factors. Patient’s education, manifesting symptoms and surgical management play a significant role on discharge outcome. The literature of same from developing country is limited. The present pilot study aims to describe patient characteristics, presenting symptom and management aspects of TBI patients from a tertiary hospital. Methods. The present study is a prospective study, where TBI patients were selected and data of injury was entered on standard proforma on electronic data base. The study was approved by institute ethical board. The data was analyzed using Stats Direct version 3.0.150 software. Results. Three hundred and thirty three patients were evaluated. Eighty percent of patients were from rural areas. About 75% of patients were illiterates and married. Patient employment was significant with discharge outcome. All the patients manifested with symptoms loss of consciousness (LOC) was higher (73%) followed by vomiting (44%). LOC and oral bleed was significant with outcome. Associated injuries was higher in extremities (22.5%) followed by chest (4.4%). About 15% of patients require intracranial surgery that was significant with discharge outcome. Conclusion. The present pilot study finding is similar to available literature data and adds knowledge to TBI data of a developing country like India.

scholarly journals Level of satisfaction in patients/attendants admitted with traumatic brain injury at an advanced ER/Casualty in a Tertiary Care Teaching Hospital

2013 ◽  
Vol 2 (2) ◽  
pp. 89
Author(s):  
M Veera Prasad ◽  
S Satish Kumar ◽  
Amit Agrawal ◽  
D Rama Mohan
Keyword(s):  
Traumatic Brain Injury ◽  
Patient Satisfaction ◽  
Brain Injury ◽  
Pilot Study ◽  
Brain Injuries ◽  
Tertiary Care ◽  
Poor Response ◽  
Validated Questionnaire ◽  
Level Of Satisfaction ◽  
Present Pilot Study

Background: The objective of the present study was to develop an instrument that could be helpful to measure the level of satisfaction with hospital services in cases of traumatic brain injuries. Methods: The present pilot study was a prospective analysis of traumatic brain injury patients. The study was approved by the institutional ethical committee. The data was collected regarding demographics, clinical presentation, management offered, complications and survival. Patient satisfaction was measured by a validated questionnaire with six domains: information, human care, comfort, visiting, intimacy, and cleanliness. The data was collected in self-administered questionnaire to measure attendants’ desires and expectations for a broad spectrum of frequently used services in a hospital. Attendants indicated their level of satisfaction by selecting responses ranging from poor=1, fair=2, good=3, very good=4 and excellent=5. Each domain was scored from excellent to poor, with higher scores indicating higher levels of patient satisfaction. Results: During the pilot study period, data for a total 86 patients was collected. The mean age was 36.81 years (Age range 6-73 years, median-35.5 years). Mean hospital stay was 9.25 days (range 2-35 days, median 6.9 days). In present study almost all the patients were brought by close relatives. Most of the patients belonged to the low socio-economic status (coolie 33/86, farmers’ 17/86). Sixty six patients made good recovery, 14 had moderate disability and 6 patients had severe disability at the time of discharge. The overall satisfaction level was classified into excellent, very good, good, average and poor. Details of the level of satisfaction and most of the time it was excellent to very good and good level of satisfaction. There were no averages or poor response. Conclusions: We believe the scores obtained from the questionnaire from present pilot study can serve as baseline against which to compare the results from future surveys.

scholarly journals Application and Limitations of Hypothermia Therapy for Traumatic Brain Injury(Traumatic Head Injury Update)

2011 ◽  
Vol 20 (12) ◽  
pp. 873-879
Author(s):  
Eiichi Suehiro ◽  
Hirosuke Fujisawa ◽  
Hiroyasu Koizumi ◽  
Hiroshi Yoneda ◽  
Hideyuki Ishihara ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Special Issue ◽  
Traumatic Head Injury ◽  
Traumatic Head

scholarly journals Clinical and Diagnostic (CT scan) Case Profile of Traumatic Brain Injury (TBI) Patients in a Teritiary Care Center, Visakhapatnam - A Retrospective Observational Study

2019 ◽  
Vol 4 (05) ◽  
Author(s):  
V. Dharma Rao ◽  
Kodandarao Kuna ◽  
Mohan Patro ◽  
Deepak M. S.
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Observational Study ◽  
Ct Scan ◽  
Road Traffic ◽  
Care Center ◽  
Seat Belt ◽  
Road Accident ◽  
Retrospective Observational Study

Introduction: India experiences increase in incidence of Road Traffic Accidents (RTA). During 1970 to 2011, there is 7.3 times increase in road accident injuries. Head injury is the commonest due to RTA injury which accounts for 60% of cases in Visakhapatnam which is situated along the 9National Highway. Aim: The aim is to study the clinical and CT scan diagnostic case profile of Traumatic brain injury (TBI) in Visakhapatnam region. Material & Methods: It is a retrospective observational study of cases of TBI reported at the trauma care center at the tetitiary care King George Hospital (KGH), Visakhapatnam, for the period 2011 – 2018. Proper permission and clearance for the present study is duly obtained. Results & Discussion: Head injury is the commonest among traumatic injuries. CT scan is performed as the gold standard diagnostic test for head injury cases. Contusions followed by Sub arachnoid hemorrhage (SAH) and Sub dural hemorrhage (SDH) are the most common CT findings. About 25% needed ventilator support. Most common cause of death is CNS injuries (42%) followed by blood loss in 39% of cases. Conclusions: Regulated traffic control, wearing helmet and seat belt, limiting speed and avoiding L & U bends at road corners can prevent and minimise the incidence of fatal injuries.

scholarly journals TP9.1.2We must do better - An audit assessing local compliance with NICE Guidelines (2014) on giving patient discharge advice regarding driving following traumatic brain injury

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Tarak Chouari ◽  
Hamza Khan ◽  
Umar Wali ◽  
Arun Shanmuganandan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Patient Discharge ◽  
Complex Activity ◽  
Traumatic Head Injury ◽  
Safe Driving ◽  
Nice Guidelines ◽  
Local Compliance ◽  
Patient Advice

Abstract Introduction Driving is a complex activity involving the coordination of a number of cognitive and physical skills, which may be impaired after head injury. It is a legal requirement that patients’ inform the licensing authority when they have sustained a head injury. Failure to do so results in possible fines, invalid insurance and prosecution. NICE recommends printed patient advice about driving once discharged following a head injury. Methods A retrospective analysis of all traumatic brain injury admissions under the surgical team over a 6 months was performed. The aim was to identify current practice regarding assisting patients to return to safe driving after head injury. Information related to patient demographics, documented driving status and advice (verbal and written) related to driving, was sought. Descriptive statistics were used to portray the results. Results 56 patients were admitted following a traumatic head injury. The average age was 77 (range of 24 to 94) Patients spent on average 4 days in hospital. Only 2 patients had their driving status documented. These two patients also had a documented occupation dependent on driving. No patients received advice specific to DVLA guidelines. Conclusion This study demonstrates that there is poor compliance with NICE guidelines. Indeed, there is a need for change in our practice. We have a duty of care for our patients and in ensuring the safety of the general public. The main limitation of this study relates to the adequacy of documentation. We provide solutions in order to tackle the findings of this audit.

scholarly journals AMBARAN FUNGSI MEMORI PADA PASIEN CEDERA KEPALA TRAUMATIK DERAJAT SEDANG DENGAN EDEMA SEREBRI

2018 ◽  
Vol 18 (2) ◽  
pp. 80-85
Author(s):  
Suherman Suherman ◽  
Ipak Nistriana ◽  
Muhammad Rizky
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Function ◽  
Head Injury ◽  
Memory Function ◽  
Healing Process ◽  
Traumatic Head Injury ◽  
Cross Sectional ◽  
Traumatic Head ◽  
Cross Sectional Design

Abstrak. Latar Belakang Cedera kepala traumatik masih menjadi penyebab utama kecacatan dan kematian di dunia. Sebagian besar terjadi pada usia produktif. Efek sekunder dari cedera kepala adalah gangguan fungsi kognitif berupa fungsi memori, visuospasial, perhatian dan konsentrasi, bahasa, kalkulasi, dan orientasi. Masih sedikitnya penelitian tentang penilaian fungsi memori pada pasien cedera kepala di Indonesia. Tujuan Memaparkan gambaran penurunan fungsi kognitif terutama fungsi memori pada pasien cedera kepala derajat sedang dengan edema serebri.Metode Studi deskriptif dengan desain potong-lintang menggunakan kuesioner MMSE dan MoCA-INA sebagai modalitas penilaian.Hasil Dari 30 pasien cedera kepala traumatik derajat sedang didapatkan rerata skor MMSE adalah 27.1±2.13 (interval 20-29). Rerata skor MoCA-INA adalah 24.4±2.99 (interval 16-28). Kedua skor menunjukkan bahwa MoCA-INA memiliki rerata yang lebih rendah dan rentang skor yang lebih luas. Domain yang paling banyak terganggu adalah fungsi memori recall (98%)Kesimpulan Secara keseluruhan pasien dengan cedera kepala traumatik dengan edema serebri mengalami gangguan fungsi memori terutama area memori eksplisit berupa fungsi recall. Tatalaksana kuratif dan rehabilitatif secara adekuat dan berkelanjutan diperlukan untuk mempercepat proses penyembuhanKata Kunci Cedera Kepala Traumatik Derajat Sedang, Fungsi Memori, MMSE, MoCA-INAAbstract. Background Traumatic brain injury is still a major cause of disability and death. Most occur in productive age. Secondary effects of brain injury are impaired cognitive function in the form of memory, visuospatial, attention and concentration, language, calculation, and orientation. There are few research on the assessment of memory function in brain injury patients in Indonesia.Purpose To describes the decreasing cognitive function, particularly memory function in patients with moderate brain injury with cerebral edema.Method Descriptive study with cross-sectional design using MMSE and MoCA-INA questionnaires as assessment modalities.Results Of the 30 patients with moderate-grade traumatic head injury, the mean MMSE score was 27.1 ± 2.13 (intervals 20-29). The average MoCA-INA score is 24.4 ± 2.99 (intervals 16-28). Both scores indicate that the MoCA-INA has a lower mean and a wider score range. The most disturbed domain is recall memory function (96%)Conclusion Overall patients with traumatic brain injury with cerebral edema experience impaired memory function, especially the area of explicit memory in the form of recall function. Adequate and sustainable curative and rehabilitative management is needed to accelerate the healing process Keywords Traumatic Head Injury Moderate Level, Memory Function, MMSE, MoCA-INA 

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