Trends in traumatic brain injury outcomes in Port Moresby General Hospital from January 2003 to December 2004

ABSTRACT

BACKGROUND: Traumatic brain injury (TBI) has been responsible for 25-30% of surgical deaths in Port Moresby General Hospital (PMGH) over the last 30 years despite being responsible for only 5% of the admissions. AIM: To document the epidemiology of TBI over a period of two years from 2003 to 2004 and compare this to the previous two decades in PMGH and elsewhere. The treatment and outcome of TBI cases are analyzed. METHODS: All TBI cases were included from January 2003 to December 2004. The Glasgow Coma Score (GCS) and Glasgow Outcome Scale (GOS) were documented at admission and discharge. These cases were followed up in the outpatient department for at least 6 months. RESULTS: There were 262 cases of TBI admitted between January 2003 and December 2004. There were 31 deaths during this period. 28 deaths were in the severe TBI category (GCS 3-8) and 3 in the moderate category (GCS 9-12). CONCLUSION: The case fatality rate of severe TBI has been reduced from 60% to just below 30% over the period of 2 years. The formation of a single unit managing TBI over two years may be one factor contributing to this improvement. Interpersonal violence has replaced motor vehicle accidents as the leading cause of death from TBI.