• N Parker, T Navsaria, M Lopez, L Marineau, R Maine, K Chu, T Govender, D McPherson, and P Navsaria.
• Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa. 22739904@sun.ac.za.
• S. Afr. Med. J. 2024 Jul 1; 114 (7): e1829e1829.

BackgroundTraumatic brain injury (TBI) can result in significant morbidity and mortality if not diagnosed in a timely manner. Brain computed tomography (CT) is the diagnostic gold standard but is of limited availability in most South African public hospitals, resulting in transfer of TBI patients to tertiary hospitals.ObjectiveTo describe the referral patterns and outcomes of patients with TBI referred to Groote Schuur Hospital Trauma Centre.MethodsThis was a retrospective audit of all patients admitted to the Trauma Centre who had a brain CT scan for suspected TBI between 1 February 2022 and 31 March 2022. Demographic data (age, sex), mechanism of injury and Glasgow Coma Score were recorded. Referral pathways were determined, and final disposition of patients was recorded.ResultsA total of 522 patients had a brain CT for TBI. Of these, 314 (60.1%) were referred from other hospitals. CT scan was abnormal in 178 (34.1%) patients. Three hundred and two (58.6%) were discharged home within 24 hours. The mean time between referral and CT scan was 13 hours.ConclusionMore than half of patients referred for a CT scan were discharged from the Trauma Centre within 24 hours of admission, which indicates additional costs and inefficiencies in the health system. These data are useful to guide resource planning and allocation for district hospitals, since less expensive point-of-care modalities now exist to diagnose TBI, and which are useful in indicating the prognosis of patients.

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