Traumatic Brain Injury in the Accident and Emergency Department of a Tertiary Hospital in Nigeria

RESUMO

Background: Traumatic brain injury is a major public health problem in Nigeria; as it could be associated with long term and life long deficits. Unlike other parts of the world; in our country; motorcycles are possibly the main cause of this injury. Unfortunately; we do not have a national epidemiological data base yet. This study was aimed at defining the peculiar demographic and associated risk factors in traumatic brain injury among our patients; as part of a multi-institutional data pool for a future meta-analysis to generate the national data base. Methods: This was a 24-month retrospective study of all head injury patients who met the criteria for traumatic brain injury in the Accident and Emergency Department of a tertiary health institution. Data were collected from the emergency cards and case notes; then collated and analyzed using the descriptive statistics on SPSS 13; with the p value taken as 0.05. Results: A total of 9;444 patients were attended to during the 24 months; 510 (5.4) of them met the inclusion criteria for the study. This translated to a presentation rate of 5.3 cases per week and an incidence rate of 2;710 per 100;000 per year. Males accounted for 404 (79.2) of the cases. The peak age incidence (31.2) was in the 20 - 30 year age group. Traders constituted the highest occupational group 125 (24.5). Most (58.8) of the cases resulted from motorcycle accident. There were 28 deaths giving a mortality rate of 5.5or 148 deaths per 100;000 per year. Conclusion: The risk factors were the male gender; motorcycle riding; illiteracy; trading; extremes of age and active daytime period of 1201 - 1800hours. The incidence rate was much higher than in the developed countries; but could reduce with the use of crash helmets; seat belts; speed limits and safety/protective vehicular devices; with better road rehabilitation