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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2018

Open Access 01-12-2018 | Research article

Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores

Authors: Samitha Samanamalee, Ponsuge Chathurani Sigera, Ambepitiyawaduge Pubudu De Silva, Kaushila Thilakasiri, Aasiyah Rashan, Saman Wadanambi, Kosala Saroj Amarasiri Jayasinghe, Arjen M. Dondorp, Rashan Haniffa

Published in: BMC Anesthesiology | Issue 1/2018

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Abstract

Background

This study evaluates post-ICU outcomes of patients admitted with moderate and severe Traumatic Brain Injury (TBI) in a tertiary neurocritical care unit in an low middle income country and the performance of trauma scores: A Severity Characterization of Trauma, Trauma and Injury Severity Score, Injury Severity Score and Revised Trauma Score in this setting.

Methods

Adult patients directly admitted to the neurosurgical intensive care units of the National Hospital of Sri Lanka between 21st July 2014 and 1st October 2014 with moderate or severe TBI were recruited.
A telephone administered questionnaire based on the Glasgow Outcome Scale Extended (GOSE) was used to assess functional outcome of patients at 3 and 6 months after injury. The economic impact of the injury was assessed before injury, and at 3 and 6 months after injury.

Results

One hundred and one patients were included in the study. Survival at ICU discharge, 3 and 6 months after injury was 68.3%, 49.5% and 45.5% respectively. Of the survivors at 3 months after injury, 43 (86%) were living at home. Only 19 (38%) patients had a good recovery (as defined by GOSE 7 and 8). Three months and six months after injury, respectively 25 (50%) and 14 (30.4%) patients had become “economically dependent”. Selected trauma scores had poor discriminatory ability in predicting mortality.

Conclusions

This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery. The social and economic consequences of TBI were long lasting in this setting. Injury Severity Score, Revised Trauma Score, A Severity Characterization of Trauma and Trauma and Injury Severity Score, all performed poorly in predicting mortality in this setting and illustrate the need for setting adapted tools.
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Metadata
Title
Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores
Authors
Samitha Samanamalee
Ponsuge Chathurani Sigera
Ambepitiyawaduge Pubudu De Silva
Kaushila Thilakasiri
Aasiyah Rashan
Saman Wadanambi
Kosala Saroj Amarasiri Jayasinghe
Arjen M. Dondorp
Rashan Haniffa
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2018
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-017-0463-7

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