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Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series

INTRODUCTION: Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilia...

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Autores principales: Mudekereza, Paterne Safari, Murhula, Gauthier Bahizire, Kachungunu, Charles, Mudekereza, Amani, Cikomola, Fabrice, Mubenga, Leon-Emmanuel Mukengeshai, Balungwe, Patrick Birindwa, Budema, Paul Munguakonkwa, Molima, Christian, Mugabo, Erick Namegabe, Lekuya, Hervé Monka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487558/
https://www.ncbi.nlm.nih.gov/pubmed/34600474
http://dx.doi.org/10.1186/s12873-021-00504-5
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author Mudekereza, Paterne Safari
Murhula, Gauthier Bahizire
Kachungunu, Charles
Mudekereza, Amani
Cikomola, Fabrice
Mubenga, Leon-Emmanuel Mukengeshai
Balungwe, Patrick Birindwa
Budema, Paul Munguakonkwa
Molima, Christian
Mugabo, Erick Namegabe
Lekuya, Hervé Monka
author_facet Mudekereza, Paterne Safari
Murhula, Gauthier Bahizire
Kachungunu, Charles
Mudekereza, Amani
Cikomola, Fabrice
Mubenga, Leon-Emmanuel Mukengeshai
Balungwe, Patrick Birindwa
Budema, Paul Munguakonkwa
Molima, Christian
Mugabo, Erick Namegabe
Lekuya, Hervé Monka
author_sort Mudekereza, Paterne Safari
collection PubMed
description INTRODUCTION: Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilians and military are frequently assaulted on the head, but paradoxically their hospital outcomes are under-reported. We aimed to identify factors associated with poor hospital outcomes of patients with PCCI. METHODS: This was a retrospective series of patients admitted at the Regional Hospital of Bukavu, DRC, from 2010 to 2020. We retrieved medical records of patients with PCCI operated in the surgical departments. A multivariate logistic regression model was performed to find associations between patients’ admission clinico-radiological parameters and hospital outcomes. Poor outcome was defined as a Glasgow Outcomes Score below 4. RESULTS: The prevalence of PCCI was 9.1% (91/858 cases) among admitted TBI patients. More than one-third (36.2%) of patients were admitted with GCS < 13, and 40.6% of them were unstable hemodynamic. Hemiplegia was found in 23.1% on admission. Eight patients had an intracerebral hemorrhage. Among the 69 operated patients, complications, mainly infectious, occurred in half (50.7%) of patients. Poor hospital outcomes were observed in 30.4% and associated with an admission GCS < 13, hemodynamic instability, intracerebral hemorrhage, and hemiplegia (p < 0.05). CONCLUSION: The hospital poor outcomes are observed when patients present with hemodynamic instability, an admission GCS < 13, intracerebral hemorrhage, and hemiplegia. There is a need for optimizing the initial care of patients with PCCI in armed conflict regions.
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spelling pubmed-84875582021-10-04 Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series Mudekereza, Paterne Safari Murhula, Gauthier Bahizire Kachungunu, Charles Mudekereza, Amani Cikomola, Fabrice Mubenga, Leon-Emmanuel Mukengeshai Balungwe, Patrick Birindwa Budema, Paul Munguakonkwa Molima, Christian Mugabo, Erick Namegabe Lekuya, Hervé Monka BMC Emerg Med Research INTRODUCTION: Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilians and military are frequently assaulted on the head, but paradoxically their hospital outcomes are under-reported. We aimed to identify factors associated with poor hospital outcomes of patients with PCCI. METHODS: This was a retrospective series of patients admitted at the Regional Hospital of Bukavu, DRC, from 2010 to 2020. We retrieved medical records of patients with PCCI operated in the surgical departments. A multivariate logistic regression model was performed to find associations between patients’ admission clinico-radiological parameters and hospital outcomes. Poor outcome was defined as a Glasgow Outcomes Score below 4. RESULTS: The prevalence of PCCI was 9.1% (91/858 cases) among admitted TBI patients. More than one-third (36.2%) of patients were admitted with GCS < 13, and 40.6% of them were unstable hemodynamic. Hemiplegia was found in 23.1% on admission. Eight patients had an intracerebral hemorrhage. Among the 69 operated patients, complications, mainly infectious, occurred in half (50.7%) of patients. Poor hospital outcomes were observed in 30.4% and associated with an admission GCS < 13, hemodynamic instability, intracerebral hemorrhage, and hemiplegia (p < 0.05). CONCLUSION: The hospital poor outcomes are observed when patients present with hemodynamic instability, an admission GCS < 13, intracerebral hemorrhage, and hemiplegia. There is a need for optimizing the initial care of patients with PCCI in armed conflict regions. BioMed Central 2021-10-02 /pmc/articles/PMC8487558/ /pubmed/34600474 http://dx.doi.org/10.1186/s12873-021-00504-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Mudekereza, Paterne Safari
Murhula, Gauthier Bahizire
Kachungunu, Charles
Mudekereza, Amani
Cikomola, Fabrice
Mubenga, Leon-Emmanuel Mukengeshai
Balungwe, Patrick Birindwa
Budema, Paul Munguakonkwa
Molima, Christian
Mugabo, Erick Namegabe
Lekuya, Hervé Monka
Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series
title Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series
title_full Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series
title_fullStr Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series
title_full_unstemmed Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series
title_short Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series
title_sort factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the democratic republic of the congo: a retrospective series
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487558/
https://www.ncbi.nlm.nih.gov/pubmed/34600474
http://dx.doi.org/10.1186/s12873-021-00504-5
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