[Intensive care management of patients with severe head traumatism in Benin from 1998 to 2002].
OBJECTIVE
To study in Cotonou (Benin) in tropical environment, the specific problems of severe head injury.


METHODS
Five years retrospective study in Cotonou University National and Teaching Hospital.


METHODS
All patients admitted with severe head injury between January 1998 and December 2002 were included. The following parameters were studied: age, sex, traumatism cause, temperature, blood pressure, Glasgow coma scale.


RESULTS
Two Hundred thirty six patients (mean age 32 +/- 18 years) essentially men, were admitted. The cause of the injury was road traffic accidents in 86% of cases. Prehospital medicalisation was achieved in only 9% of cases. A head CT-scan was performed in 5% of the cases. Respiratory resuscitation essentially used the association intubation and oxygenation (59%), 19% of the patients were ventilated and 21% were sedated. Mortality was closely related to the initial Glasgow coma scale score (GCS): GCS 3-4 = 97%; GCS 5-6 = 72% GCS 7-8 = 36%. Overall mortality was 70%.


CONCLUSIONS
Severe head injury is a major cause of morbidity and mortality in developing countries. Limited access to highly specialised care explain a high mortality rate. An active policy of prevention from administrative authorities and a greater effectiveness of medical management may improve outcome.
Aguèmon
A R
AR
Service polyvalent d'anesthésie-réanimation, centre national hospitalier et universitaire HK MAGA 06 BP 416 Akpakpa-PK3, Cotonou, Bénin. aguemon_c@yahoo.fr
Padonou
J L
JL
Yévègnon
S R
SR
Hounkpè
P C
PC
Madougou
S
S
Djagnikpo
A K
AK
Atchadé
D
D
D000063:Accidents, Traffic; D000328:Adult; D000367:Age Factors; D001541:Benin / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature; D016887:Cardiopulmonary Resuscitation; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D003422:Critical Care; D004632:Emergency Medical Services; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D012025:Reflex, Pupillary; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012737:Sex Factors; D014057:Tomography, X-Ray Computed