Analysis of Traumatic Head Injury in Kathmandu, Nepal

Abstract

Abstract Degree Project thesis, Programme in Medicine Analysis of Traumatic Head Injury in Kathmandu, Nepal Erik Stenholm, Student of Medicine Supervisor: Prof. Mohan Raj Sharma. Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Background Nepal is one of the worlds poorest countries. Traumatic brain injury (TBI) is a major strain on Nepal’s healthcare. The fatalities are about 15-20 times higher than in more developed countries such as Sweden. More studies about TBI are crucial in order to decrease mortality and morbidity. Objectives The objective of the study us to characterise patients who are admitted to a neurosurgical tertiary care centre at Tribhuvan University Teaching Hospital (TUTH) and to assess the value of Glasgow Coma Scale (GCS) at admission and if surgery affects the outcome. An auxiliary aim is to study if the results differs between men and women. Methods In a prospective observation study, information about patients admitted to the neurosurgical tertiary care centre at TUTH was collected during October and November 2015. Inclusion criteria were: admitted with a brain injury caused by trauma and age of 16 or more. The severity of the injuries was classified with GCS. The outcome was classified with Glasgow Outcome Score (GOS). Results A total of 46 patients were included, 33 males and 13 females. The most common modes of injury were fall from ground/heights and road traffic accidents. Patients admitted with GCS 3- 8 had worse outcome (-1.5 GOS, p=0.002) than patients admitted with GCS 13-15. In patients who had undergone surgery the outcome tended to be worse (-0.5 GOS, p=0.097). The most common mode of injury was fall from ground/heights and road traffic accidents. Conclusions GCS at admission can be used to predict the outcome of patients with TBI. Surgery worsened the outcome but this was not statistically confirmed. A study with larger sample needs to be done to analyse differences between males and females.