Outcomes of severe traumatic brain injury at time of discharge from tertiary academic hospitals in Bloemfontein

BACKGROUND: Despite the condition being a major public health concern, limited data are available regarding survival rates and the requirement for post-hospitalisation support of patients with traumatic brain injury (TBI) in South Africa (SA). OBJECTIVES: To describe the clinical profile and in-hospital outcomes of patients with TBI at intensive care units (ICUs) of tertiary referral hospitals in the Free State Province, SA, between 2013 and 2017. METHODS: This retrospective descriptive study of patients with TBI was conducted at Pelonomi Tertiary and Universitas Academic Hospitals. Patients’ demographic information and variables such as mechanism and type of injury, Glasgow Coma Scale (GCS) prior to ICU admission, neurosurgical intervention, duration of stay in ICU and hospital, GCS and final outcome at discharge were recorded. RESULTS: The 138 patients included in the final data analysis had a median (range) age of 30.5 (13 - 70) years, with a male predominance of 82.6%. The median lengths of stay in ICU and hospital were 6 and 16 days, respectively. Outcomes data showed that 65.9% of patients survived until discharge from hospital. Of patients whose GCS could be determined at discharge, 52.8% were deceased, 7.9% were in a persistently vegetative state, 11.2% had severe and 13.5% moderate disability, and 14.6% had a good recovery. CONCLUSION: TBI is associated with high mortality and morbidity. The lack of post-hospitalisation rehabilitation, and support for patients and their caregivers, requires urgent redress.