Traumatic brain injury: Clinical patterns and predictive factors in a rural hospital setting

Objectives: Traumatic brain injury (TBI) is a major cause of emergency visits, primarily due to traffic accidents. However, data on TBI in rural or semi-urban Indonesian district hospitals are limited. This study aims to describe TBI clinical characteristics and identify factors influencing outcomes. Materials and Methods: A retrospective study was conducted at Bangli General Hospital, Bali, Indonesia, including all TBI patients admitted from January 2023 to April 2025. Data from medical records were analyzed for factors affecting outcomes and significant variables were included in multivariate analysis. Results: The study included 568 patients, with a 4.8% mortality rate. Most were male (55.1%) and aged 19–45 years (32.2%). The majority had mild TBI (86%), isolated head trauma (83.6%), and a history of loss of consciousness (74.6%). Traffic accidents were the leading cause (56.7%), with 57.4% arriving within 0–1 h. Radiography showed no bleeding in 71.8% and no fractures in 84.5%. Independent factors linked to in-hospital death included older age (odds ratio (OR) 4.06; 95% confidence interval (CI) 1.81–9.09; p = 0.001), severe glasgow coma scale (GCS) (OR 5.54; 95% CI 1.21–25.07; p < 0.001), polytrauma (OR 5.49; 95% CI 1.21–25.07; p = 0.028), higher number of bleeding (OR 2.61; 95% CI 1.41–4.84; p = 0.002), and the presence of skull fracture (OR 4.46; 95% CI 1.63–12.22; p = 0.004). Conclusion: TBI patients in district hospitals were mainly adults with mild cases due to traffic accidents. Key risk factors for death include age, GCS, trauma type, bleeding, and skull fractures.