Clinical Management and Outcomes of Traumatic Brain Injury: A Comparative Study of High-Resource and Low-Resource Hospital Settings.”

To compare management strategies and outcomes of TBI in high-resource versus low-resource hospital settings. Methodology: This multicenter, prospective observational study included all patients with traumatic brain injury. Data was collected using a standardized questionnaire that included demographics, medical history, injury details, GCS scores and GOSE outcomes. A brain CT scan was performed within 24 hours of injury, and follow-up assessments were conducted at two weeks. Statistical analysis was performed using SPSS version 27, with chi-square test and logistic regression used to assess associations between variables and hospitals. Results: Among 124 traumatic brain injury patients, 74% were males with mean age of 41.63 +/- 15.39; and 40.3% aged between 31–50 years, equally distributed between low- and high-resource hospitals. Road traffic accidents caused 75% of injuries, with 39.5% classified as severe TBI. Surgical interventions were performed more frequently in high-resource settings (22.6% vs. 4.8%). Majority of low-resource patients (82.3%) had hospital stays ?3 days compared to 48.4% in high-resource hospitals. At two weeks, unfavorable outcomes (GOSE) were more common in low-resource hospitals (41.9% vs. 33.9%). Co-morbidities increased the likelihood of unfavorable outcomes (OR = 10.868, p = 0.066), as did peripheral injuries (OR = 1.332, p = 0.708). Mild (OR = 0.002, p < 0.001) and moderate (OR = 0.024, p < 0.001) TBI significantly reduced the risk of unfavorable outcomes compared to severe TBI. Conclusion: In high-resource settings, a larger proportion of patients experienced severe traumatic brain injuries, underwent surgical interventions, had longer hospital stays and showed relatively better recovery outcomes.

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Publication Details

Journal
Pakistan Journal Of Neurological Surgery
Published
2025-03-01
DOI
https://doi.org/10.36552/pjns.v29i1.1066
Primary Topic
Trauma and Emergency Care Studies
Type
article
Field-Weighted Citation Impact
0.00
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article

Clinical Management and Outcomes of Traumatic Brain Injury: A Comparative Study of High-Resource and Low-Resource Hospital Settings.”

Shaheen Akhter, Attiya Sabeen Rahman, Saba Zaidi, Aizza Zafar et al.
Pakistan Journal Of Neurological Surgery
Trauma and Emergency Care Studies
article

Clinical Management and Outcomes of Traumatic Brain Injury: A Comparative Study of High-Resource and Low-Resource Hospital Settings.”

Shaheen Akhter, Attiya Sabeen Rahman, Saba Zaidi, Aizza Zafar, Haneea Yasir
article en

Abstract

To compare management strategies and outcomes of TBI in high-resource versus low-resource hospital settings. Methodology: This multicenter, prospective observational study included all patients with traumatic brain injury. Data was collected using a standardized questionnaire that included demographics, medical history, injury details, GCS scores and GOSE outcomes. A brain CT scan was performed within 24 hours of injury, and follow-up assessments were conducted at two weeks. Statistical analysis was performed using SPSS version 27, with chi-square test and logistic regression used to assess associations between variables and hospitals. Results: Among 124 traumatic brain injury patients, 74% were males with mean age of 41.63 +/- 15.39; and 40.3% aged between 31–50 years, equally distributed between low- and high-resource hospitals. Road traffic accidents caused 75% of injuries, with 39.5% classified as severe TBI. Surgical interventions were performed more frequently in high-resource settings (22.6% vs. 4.8%). Majority of low-resource patients (82.3%) had hospital stays ?3 days compared to 48.4% in high-resource hospitals. At two weeks, unfavorable outcomes (GOSE) were more common in low-resource hospitals (41.9% vs. 33.9%). Co-morbidities increased the likelihood of unfavorable outcomes (OR = 10.868, p = 0.066), as did peripheral injuries (OR = 1.332, p = 0.708). Mild (OR = 0.002, p < 0.001) and moderate (OR = 0.024, p < 0.001) TBI significantly reduced the risk of unfavorable outcomes compared to severe TBI. Conclusion: In high-resource settings, a larger proportion of patients experienced severe traumatic brain injuries, underwent surgical interventions, had longer hospital stays and showed relatively better recovery outcomes.

Pakistan Journal Of Neurological SurgeryVol. 29(1)
Liaquat National Hospital (PK), Abbasi Shaheed Hospital (PK)
Openalex Percentile: Top 76%
Trauma and Emergency Care Studies
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