• Tsegazeab Laeke, Abenezer Tirsit, Finot Debebe, Biruk Girma, Desalegn Gere, Kee B Park, and Aklilu Azazh.
• Neurosurgery Unit, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK. Electronic address: tselaeke@gmail.com.
• World Neurosurg. 2019 Jul 1; 127: e186-e192.

BackgroundConsistent data on head injury is lacking especially in the low- and middle-income countries. Our study tries to characterize patients with head injury at the emergency department of one of the few tertiary public hospitals giving neurosurgical care in the country.MethodsA retrospective cross-sectional study was performed from May 2015 to October 2015 in one of the neurosurgical teaching hospitals, Black Lion Specialized Hospital. All adult patients with head injury who visited the emergency department during the study period were included. Data on patients' sociodemographic, mechanism of trauma, clinical presentation, imaging findings, and presence of polytrauma were collected by a pretested questionnaire. The source of data was emergency department logbooks and patient charts.ResultsA total of 390 patients with head injury who visited the emergency department were included during the study period. There were 335 males (85.9%) and 55 females (14.1%) with the mean age (standard deviation) of 35.4 (15.6) years. Majority of patients came by taxi constituting 149 (38.2%) of all patients, whereas 147 patients (37.7%) used ambulance. Of 147 patients brought by ambulances, 133 (90.4%) were referred from other hospitals. The majority, 26 (45.6%), of patients who came directly to the emergency department used taxis. It is shown that the mode of arrival and origin of arrival are significantly related, P = 0.000. Mortality of severe head injury at the emergency department was 50.8%.ConclusionsPrehospital care coverage was low and ambulances were used mainly for interhospital transfers. Mortality of severe head injury at the emergency department is high and significantly associated with preventable causes like vital sign derangement.Copyright © 2019 Elsevier Inc. All rights reserved.

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