Injury patterns in patients with severe traumatic brain injuries from motor crashes admitted to Mulago hospital accidents & emergency unit

BACKGROUND: The global burden of Road Traffic Crashes (RTC) is increasing. Uganda has one of the highest rates of RTCs in Sub-Sahara. Victims of RTCs sustain varying degrees of injuries depending on factors including the velocity at time of impact, protective gear; and if it was a motorcycle–motorcycle or motorcycle–vehicle crash. High speed collisions can result in severe forms of injuries and polytrauma. Some injuries are undetected. METHODS: A cross sectional study was carried at Mulago Hospital Accidents & Emergency Unit, between November 2021 and February 2022; on all adult patients (≥18 years) with severe head injury from motor road traffic crashes. The study looked at injury patterns and assessed the relationship of polytrauma in patients with severe head injury to the mechanism of injury (motorcycles versus vehicles). Data were extracted from patient charts using a validated data abstraction tool and complete head to toe physical examination was carried out and injuries recorded. Data were analysed to determine the relationship of polytrauma in patients with severe head injury to the mechanism of injury. RESULTS: The participants were predominantly males with a population median age of 32 (25-39). The commonest modes of transportation of patients to the hospital were Police Pickup trucks (40%) and ambulance (36.1%). Among motorcycle RTCs, (19.2%) wore helmets; 21.2% had protective gear; with injury identified mainly in; the limbs (84.8%), neck (76.8%), chest (39.4%), and abdomen (26.3%). Patients from vehicle RTCs were 19% more likely to have polytrauma compared to patients from motorcycle RTCs. CONCLUSIONS: This study showed that patients who sustain severe traumatic brain injuries from vehicle crashes have an increased likelihood of having multiple injuries, compared to patients from motorcycle RTCs. For motorcycle users, injuries mostly affect the limbs. At particular risk are motorcyclists who do not wear helmets and protective coveralls.