scholarly journals Understanding family caregiving for individuals with traumatic brain injury after a road traffic crash in Oman

Author(s):  
Roopa Koshy McCall
2021 ◽  
Author(s):  
Zuriyash Mengistu ◽  
Ahmed Ali ◽  
Teferi Abegaz

Abstract Background Traumatic brain injury (TBI) is one of the common preventable causes of mortality and disability among road traffic victims worldwide, most especially in low- and middle-income countries, including Ethiopia. Objective to determine risk factors of mortality after traumatic brain injury due to road traffic crash. Methods This study aimed to examine the predictive factors of short-term mortality after severe brain injury due to a road traffic crash. The study was done on a prospective cohort of 242 severely brain-injured patients selected using cluster sampling in Addis Ababa City hospitals. The study was conducted from February 2018 to November 2019. Data were collected from brain-injured patients using a questionnaire and recorded findings within the first 24 hours of admission, Survival Analysis was used for statistical analysis. Ethical clearance was obtained from the Addis Ababa University, College of Health Sciences Institutional Review Board (IRB). Confidentiality of information about injured patients was maintained. Results In this study, the death rate was 73(30.2%). The majority of TBI patients accounting for, 186(81%) were men. The median age of TBI patients was 29 years. The hazard for those patients with subnormal body temperature was 1.64 times that of normal temperature (AHR: 1.64; CI: 2.14-10.29). The estimated fatality hazard ratio for patients who experienced Glasgow Coma Scale (GCS)below six was 5.61 times higher compared to GCS six to eight (CI:3.1-10.24). Conclusion In conclusion, there was high early mortality of patients (30.2%) in Ethiopia. Being men, young and lower GCS were associated with higher mortality hazards. Hence, optimum advanced neuro-surgical pre-hospital care programs are urgently needed.


Author(s):  
Gopal Krishna ◽  
Varun Aggarwal ◽  
Ishwar Singh

Abstract Introduction Traumatic brain injury (TBI) affects the coagulation pathway in a distinct way than does extracranial trauma. The extent of coagulation abnormalities varies from bleeding diathesis to disseminated thrombosis. Design Prospective study. Methods The study included 50 patients of isolated TBI with cohorts of moderate (MHI) and severe head injury (SHI). Coagulopathy was graded according to the values of parameters in single laboratory. The incidence of coagulopathy according to the severity of TBI and correlation with disseminated intravascular coagulation (DIC) score, platelets, prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, and fibrinogen was observed. The comparison was also made between expired and discharged patients within each group. It also compared coagulation derailments with clinical presentation (Glasgow Coma Scale [GCS]) and outcome (Glasgow Outcome Scale [GOS]). Results Road traffic accident was the primary (72%) mode of injury. Fifty-two percent had MHI and rest had SHI. Eighty-four percent of cases were managed conservatively. The mean GCS was 12.23 and 5.75 in MHI and SHI, respectively. Sixty-two percent of MHI and 96% of the patients with SHI had coagulation abnormalities. On statistical analysis, DIC score (p < 0.001) strongly correlated with the severity of head injury and GOS. PT and APTT were also significantly associated with the severity of TBI. In patients with moderate TBI, D-dimer and platelet counts showed association with clinical outcome. Fibrinogen levels did not show any statistical significance. The mean platelet counts remained normal in both the groups of TBI. The mean GOS was 1.54 and 4.62 in SHI and MHI, respectively. Conclusion Coagulopathy is common in isolated TBI. The basic laboratory parameters are reliable predictors of coagulation abnormalities in TBI. Coagulopathy is directly associated with the severity of TBI, GCS, and poor outcome.


2016 ◽  
Vol 22 (Suppl 2) ◽  
pp. A62.2-A62
Author(s):  
Audrey Luxcey ◽  
Emmanuel Lagarde ◽  
Sylviane Lafont ◽  
Marie Zins ◽  
Benjamin Contrand ◽  
...  

Author(s):  
Jelena Kovacevic ◽  
Ivica Fotez ◽  
Ivan Miskulin ◽  
Davor Lesic ◽  
Maja Miskulin ◽  
...  

This study aimed to investigate factors associated with the symptoms of mental disorders following a road traffic crash (RTC). A prospective cohort of 200 people was followed for 6 months after experiencing an RTC. The cohort was comprised of uninjured survivors and injured victims with all levels of road traffic injury (RTI) severity. Multivariable logistic regression analyses were performed to evaluate the associations between the symptoms of depression, posttraumatic stress disorder and anxiety one and six months after the RTC, along with sociodemographic factors, health status before and after the RTC, factors related to the RTI and factors related to the RTC. The results showed associations of depression, anxiety, and posttraumatic stress disorder symptoms with sociodemographic factors, factors related to the health status before and after the RTC and factors related to the RTC. Factors related to the RTI showed associations only with depression and posttraumatic stress disorder symptoms. Identifying factors associated with mental disorders following an RTC is essential for establishing screening of vulnerable individuals at risk of poor mental health outcomes after an RTC. All RTC survivors, regardless of their RTI status, should be screened for factors associated with mental disorders in order to successfully prevent them.


2013 ◽  
Vol 52 ◽  
pp. 162-170 ◽  
Author(s):  
Hong Son Nghiem ◽  
Luke B. Connelly ◽  
Susan Gargett

2020 ◽  
Vol 11 (1) ◽  
pp. 39-43
Author(s):  
Zubair Ahmed Khan ◽  
Habib sultan ◽  
Amir Aziz ◽  
Shahrukh Rizvi ◽  
Tauqeer Ahmed ◽  
...  

ABSTRACT:BACKGROUND & OBJECTIVE: To compare the results of surgically operated vs conservatively treated patients of cerebral contusions due to traumatic brain injury. METHODOLOGY: This comparative study was conducted from January 2012 to December 2014 at the department of Neurosurgery, PGMI Lahore General Hospital, Lahore. A total of 50 patients were included in this study of both gender (male and female) and in the age range of 15-65 years. In our study 20 patients were managed conservatively while other 30 patients were operated for cerebral contusions. The mode of injury in our study was road traffic accidents and history of falls. RESULTS: Out of 50 patients, there were 41 (82%) males and 09 (18%) female patients. Their age ranged from 15 - 65 years. In this study the overall mean age is 38.36 years. The maximum numbers of patients were in their third and fourth decades of life. In our study the duration of hospital stay in conservatively managed patients was longer as compared to surgically treated patients who were discharged earlier. Mortality rate in surgically managed patients having a GCS ranged between 09 to 12 was very low contrary to the conservatively managed group, similarly the rate of delayed contusion formation and edema was also low in surgically managed patients as compared to those who were managed conservatively. CONCLUSION: Surgically managed patients of cerebral contusions in traumatic brain injury has better outcome and decreased hospital stay as compared to conservatively managed patients.


2021 ◽  
Author(s):  
Maria Khan ◽  
Uzair Yaqoob ◽  
Zair Hassan ◽  
Muhammad Muizz Uddin

Abstract Background: Traumatic Brain Injury (TBI) is the leading cause of morbidity and mortality all over the world and the impact is much worse in Pakistan. The objective here is to describe the epidemiological characteristics of patients with TBI in our country and to determine the immediate outcomes of patients with TBI after the presentation.Method: This was a cross-sectional study conducted at the Lady Reading Hospital, Peshawar, Pakistan. Data were extracted from the medical records from January 1st to December 31st, 2019. Patient age, sex, type of trauma, and immediate outcome of the referral to the Emergency Department were recorded. The severity of TBI was categorized based on Glasgow Coma Scale (GCS) in mild (GCS 13-15), moderate (GCS 9-12), and severe (GCS <8) classes. The Emergency Department referral profile was classified as admissions, disposed, detained and disposed, referred.Results: Out of 5047 patients, 3689 (73.1%) males and 1358 (26.9%) females. The most commonly affected age group was 0-10 years (25.6%) and 21-30 years (20.1%). Road Traffic accident was the predominant cause of injury (38.8%, n=1960) followed by fall (32.7%, n=1649). Most (93.6%, n=4710) of the TBIs were mild. After the full initial assessment and workup, and completing all first-aid management, the immediate outcome was divided into four, most frequent (67.2%, n=3393) of which was “disposed (discharged)”, and 9.3% (n=470) were admitted for further management.Conclusion: Our study represents a relatively commonplace picture of epidemiological data on the burden of TBI in Pakistan. As a large proportion of patients had a mild TBI, and there is a high risk of mild TBI being under-diagnosed, we warrant further investigation of mild TBI in population-based studies.


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