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CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(03): 416-422
DOI: 10.1055/s-0042-1750786
Original Article

Traumatic Brain Injury Cases' Mortality Predictors, Association, and Outcomes in the Emergency Department at a Tertiary Healthcare Center in Saudi Arabia

Ali S. Al-Shareef
1   King Abdulaziz Medical City, Jeddah, Saudi Arabia
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
,
Majid Al Thaqafi
1   King Abdulaziz Medical City, Jeddah, Saudi Arabia
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
,
Moajeb Alzahrani
1   King Abdulaziz Medical City, Jeddah, Saudi Arabia
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
,
Afnan M. Samman
1   King Abdulaziz Medical City, Jeddah, Saudi Arabia
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
,
Abdullah AlShareef
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
,
Ahmad Alzahrani
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
,
Ali Alzahrani
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
,
Ali Rio
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
,
Bassam Hariri
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
,
Majed Ramadan
2   King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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Abstract

Aim Incidence of traumatic brain injury (TBI) in Saudi Arabia has been estimated to be 116 per 1,00,000 population as incidence of TBI continues to rise in our region. We aim to study the demographics, mortality predictors, and factors influencing the outcome of TBI cases in a tertiary care center in Jeddah, Saudi Arabia.

Materials and Methods We retrospectively collected data from all consecutive patients treated at the Emergency Department of King Abdulaziz Medical City including all acute TBI adult cases (>18 years) from 2016 to 2019. Logistic regression models were used to identify significant predictors of mortality. A total of 423 individuals with TBI were enrolled in the study. Nearly, half of them were in age group of 18 to 29 (40.77). Most patients were males (76.83%).

Results Injuries were most commonly mild-to-moderate TBI (73.83%). Road traffic accident was the most common mechanism of injury (49.7%) followed by fall (39.5%). Most common mode of transportation was private cars (47.57%). Most patient required less than or equal to24hours of admission (61.23%). A total of 30 (7%) died in the hospital all of which were male with no death cases reported among females.

Conclusion In conclusion, this study reports a mortality rate related to TBI that is among the lowest in the region. Injuries were male predominant with more balanced male to female ratio. Patients who were delivered to the hospital via private cars had an improved survival. These finding should be interpreted in the context of retrospective noncontrolled study design, and further future studies are encouraged to consolidate these findings.

Keywords

traumatic brain injury outcomes - emergency department - Saudi Arabia


Publication History

Article published online:
09 September 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Liu C, Xie J, Xiao X. et al. Clinical predictors of prognosis in patients with traumatic brain injury combined with extracranial trauma. Int J Med Sci 2021; 18 (07) 1639-1647
    CrossrefPubMedGoogle Scholar
  • 2 Algahtany MA. Secular trend, seasonal variation, epidemiological pattern, and outcome of traumatic head injuries due to road traffic accidents in Aseer, Saudi Arabia. Int J Environ Res Public Health 2021; 18 (12) 6623 DOI: 10.3390/ijerph18126623.
    CrossrefPubMedGoogle Scholar
  • 3 Al-Kuwaiti A, Hefny AF, Bellou A, Eid HO, Abu-Zidan FM. Epidemiology of head injury in the United Arab Emirates. Ulus Travma Acil Cerrahi Derg 2012; 18 (03) 213-218
    CrossrefPubMedGoogle Scholar
  • 4 Peeters W, van den Brande R, Polinder S. et al. Epidemiology of traumatic brain injury in Europe. Acta Neurochir (Wien) 2015; 157 (10) 1683-1696
    CrossrefPubMedGoogle Scholar
  • 5 Herrera-Melero MC, Egea-Guerrero JJ, Vilches-Arenas A. et al. Acute predictors for mortality after severe TBI in Spain: gender differences and clinical data. Brain Inj 2015; 29 (12) 1439-1444
    CrossrefPubMedGoogle Scholar
  • 6 Ullah S, Bin Ayaz S, Moukais IS. et al. Factors affecting functional outcomes of traumatic brain injury rehabilitation at a rehabilitation facility in Saudi Arabia. Neurosciences (Riyadh) 2020; 25 (03) 169-175
    CrossrefPubMedGoogle Scholar
  • 7 Flaada JT, Leibson CL, Mandrekar JN. et al. Relative risk of mortality after traumatic brain injury: a population-based study of the role of age and injury severity. J Neurotrauma 2007; 24 (03) 435-445
    CrossrefPubMedGoogle Scholar
  • 8 Okidi R, Ogwang DM, Okello TR. et al. Factors affecting mortality after traumatic brain injury in a resource-poor setting. BJS Open 2020; 4 (02) 320-325
    CrossrefPubMedGoogle Scholar
  • 9 Al-Hajj S, Hammoud Z, Colnaric J. et al; TBI Working Group. Characterization of traumatic brain injury research in the Middle East and North Africa region: a systematic review. Neuroepidemiology 2021; 1-12 DOI: 10.1159/000511554. . PMID: 33567436
    CrossrefPubMedGoogle Scholar
  • 10 Abou-Abbass H, Bahmad H, Ghandour H. et al. Epidemiology and clinical characteristics of traumatic brain injury in Lebanon: a systematic review. Medicine (Baltimore) 2016; 95 (47) e5342
    CrossrefPubMedGoogle Scholar
  • 11 Saudi Youth in Numbers. A report for International Youth Day 2020. Statistical Analysis and Decision Support Center, General Authority for statistics, Saudi Arabia. Accessed May 8, 2022 https://www.stats.gov.sa/sites/default/files/saudi_youth_in_numbers_report_2020en_0.pdf
    Google Scholar
  • 12 Al-Habib A, A-Shail A, Alaqeel A. et al. Causes and patterns of adult traumatic head injuries in Saudi Arabia: implications for injury prevention. Ann Saudi Med 2013; 33 (04) 351-355
    CrossrefPubMedGoogle Scholar
  • 13 Thomas KE, Stevens JA, Sarmiento K, Wald MM. Fall-related traumatic brain injury deaths and hospitalizations among older adults–United States, 2005. J Safety Res 2008; 39 (03) 269-272
    CrossrefPubMedGoogle Scholar
  • 14 Peterson AB, Kegler SR. Deaths from fall-related traumatic brain injury - United States, 2008-2017. MMWR Morb Mortal Wkly Rep 2020; 69 (09) 225-230
    CrossrefPubMedGoogle Scholar
  • 15 Santos ME, Agrela N. Traumatic brain injury in Portugal: progress in incidence and mortality. Brain Inj 2019; 33 (12) 1552-1555
    CrossrefPubMedGoogle Scholar
  • 16 Kim HK, Leigh JH, Lee YS. et al. Decreasing incidence and mortality in traumatic brain injury in Korea, 2008-2017: a population-based longitudinal study. Int J Environ Res Public Health 2020; 17 (17) 6197
    CrossrefPubMedGoogle Scholar
  • 17 Alnaami I, Alshehri S, Alghamdi S. et al. Patterns, types, and outcomes of head injury in Aseer region, Kingdom of Saudi Arabia. Neurosci J 2019; 2019: 2782146
    CrossrefPubMedGoogle Scholar
  • 18 Arabi YM, Haddad S, Tamim HM. et al. Mortality reduction after implementing a clinical practice guidelines-based management protocol for severe traumatic brain injury. J Crit Care 2010; 25 (02) 190-195
    CrossrefPubMedGoogle Scholar
  • 19 Stranjalis G, Komaitis S, Kalyvas AV. et al. Recent trends (2010-2018) in traumatic brain injury in Greece: results on 2042 patients. Injury 2020; 51 (09) 2033-2039
    CrossrefPubMedGoogle Scholar
  • 20 Ibrahimova A, Shults RA, Beck LF. Comparison of 2008 national and state-level self-reported and observed seatbelt use estimates. Inj Prev 2011; 17 (03) 201-203
    CrossrefPubMedGoogle Scholar
  • 21 Alghnam S, Alkelya M, Alfraidy M, Al-Bedah K, Albabtain IT, Alshenqeety O. Outcomes of road traffic injuries before and after the implementation of a camera ticketing system: a retrospective study from a large trauma center in Saudi Arabia. Ann Saudi Med 2017; 37 (01) 1-9
    CrossrefPubMedGoogle Scholar
  • 22 Richards D, Carroll J. Relationship between types of head injury and age of pedestrian. Accid Anal Prev 2012; 47: 16-23
    CrossrefPubMedGoogle Scholar
  • 23 Wandling MW, Nathens AB, Shapiro MB, Haut ER. Association of prehospital mode of transport with mortality in penetrating trauma: a trauma system-level assessment of private vehicle transportation vs ground emergency medical services. JAMA Surg 2018; 153 (02) 107-113
    CrossrefPubMedGoogle Scholar
  • 24 Johnson NJ, Carr BG, Salhi R, Holena DN, Wolff C, Band RA. Characteristics and outcomes of injured patients presenting by private vehicle in a state trauma system. Am J Emerg Med 2013; 31 (02) 275-281
    CrossrefPubMedGoogle Scholar
  • 25 Huber S, Crönlein M, von Matthey F. et al; TraumaRegister DGU. Effect of private versus emergency medical systems transportation in trauma patients in a mostly physician based system- a retrospective multicenter study based on the TraumaRegister DGU®. Scand J Trauma Resusc Emerg Med 2016; 24: 60
    CrossrefPubMedGoogle Scholar
  • 26 Aljerian N, Alhaidar S, Alothman A, AlJohi W, Albaqami FA, Alghnam SA. Association between the mode of transport and in-hospital medical complications in trauma patients: findings from a level-I trauma center in Saudi Arabia. Ann Saudi Med 2018; 38 (01) 8-14
    CrossrefPubMedGoogle Scholar
  • 27 Al-Shaqsi S, Al-Kashmiri A, Al-Hajri H, Al-Harthy A. Emergency medical services versus private transport of trauma patients in the Sultanate of Oman: a retrospective audit at the Sultan Qaboos University Hospital. Emerg Med J 2014; 31 (09) 754-757
    CrossrefPubMedGoogle Scholar