title: Outcomes of intensive care management of traumatic brain injury in a resource-challenged tertiary health centre.
abstract: BACKGROUND
  Improved surgical care and protocol-driven intensive care interventions for head injured patients have contributed to the overall reduction in mortality in developed countries. The aim of this study is to highlight the clinical outcomes of patients with severe traumatic brain injury managed in the multispecialty ICU of our institution.
  
  
  METHODS
  The medical records of all patients with severe TBI managed in our 3-bedded non-dedicated ICU over a 24-month period were reviewed. Data on demographic characteristics, mechanism of injury, neuroimaging and interventions were obtained and the primary outcome measure was the mortality.
  
  
  RESULTS
  Fifty one patients, age ranged from 2-75 years and median age of 30 years were studied. The male sex was more involved (M;F of 12;1) and motorcycle crashes caused the majority of the injury (19,{37%}). None of the patients received pre-hospital care and about half (25 {49 %}) presented six hours post trauma. Cranial CT scan showed intracranial haemorrhage in 7 of the 21 patients stabled for neuroimaging. Overall mortality was 70%, with highest mortality recorded in those who did not have post injury brain CT scan (58% vs 82%, p = 0.066).
  
  
  CONCLUSIONS
  Mortality from severe TBI is very high in our environment where routine pre-hospital care and prompt transfer to neurosurgical centres are not practiced. Lack of facilities for monitoring intracranial pressure and arterial blood gases in our ICU also contributed to the high mortality.
authors.affiliation: Department of Anaesthesia, University of Ilorin, Ilorin, Nigeria.
authors.forename: A S
authors.initials: AS
authors.lastname: Yusuf
authors.forename: Z A
authors.initials: ZA
authors.lastname: Suleiman
authors.forename: I
authors.initials: I
authors.lastname: Olaoye
authors.forename: B O
authors.initials: BO
authors.lastname: Bolaji
authors.forename: N A
authors.initials: NA
authors.lastname: Adeleke
authors.forename: T O
authors.initials: TO
authors.lastname: Odebode
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D004865:Equipment and Supplies, Hospital / Q000600:supply & distribution; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult