• World Neurosurg · Oct 2020

    Prehospital Conditions and Outcomes following Craniotomy for Traumatic Brain Injury Performed within 72 Hours in Central Cameroon: A Cross-Sectional Study.

    • Régis Takoukam, Ulrick Sidney Kanmounye, Faith C Robertson, Kathrin Zimmerman, Stéphane Nguembu, Jean W Lartigue, Kee B Park, Bello Figuim, and Ignatius Esene.
    • Faculty of Medicine, Higher Institute of Health Sciences, Université des Montagnes, Bangangte, Cameroon; Department of Neurosurgery, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Department of Research, Association of Future African Neurosurgeons, Yaounde, Cameroon.
    • World Neurosurg. 2020 Oct 1; 142: e238-e244.

    BackgroundTraumatic brain injury (TBI) is the most common neurosurgical condition globally. In Cameroon, there are 572 cases of TBI per 100,000 people, but <40% of Cameroonians live within 4 hours of a neurosurgical facility. We sought to understand the clinical outcomes at a neurosurgical center in Central Cameroon.MethodsThis cross-sectional study was conducted at the largest neurosurgical center of Cameroon, the Yaounde Central Hospital. Data included 100 consecutive patients undergoing an intervention 72 hours after their injury from February 1, 2015 to February 1, 2019. Patients with missing data or undergoing surgery >72 hours after injury were excluded. Analyses of covariance were performed, and a P value >0.05 was considered significant. A Kaplan-Meier survival curve was computed.ResultsThe patients had a mean age of 31.3 ± 17.4 years, with a male predominance of 91.0%, and the principal mechanism of injury was road traffic accidents (68.0%). Only 11% arrived via ambulance, and 36.0% were admitted <3 hours after the traumatic event. The postoperative mortality was 15.0%, mean survival was 25.0 postoperative days (95% confidence interval, 23.42-26.52), and the mean Glasgow Outcome Scale score at 28 days was 3.9 ± 1.4.ConclusionsMost patients with TBI undergoing neurosurgery 72 hours after injury in Cameroon arrive at the hospital late and have a high mortality risk during the first postoperative week. Investments in prehospital care should be made to improve surgical outcomes.Copyright © 2020 Elsevier Inc. All rights reserved.

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