Abstract:
Background: Traumatic brain injury is a global health problem with significant mortality and
morbidity. The study aimed at determining the outcomes of mild traumatic brain injured
patients during 24 hours of observation among patients admitted at Muhimbili Orthopedic,
Trauma and Neurosurgical Institute (MOI) - Tanzania.
Study design: Prospective – Hospital base d observation study. All consecutive patients with
mild traumatic brain injury meeting the inclusion criteria were recruited in the study and
followed up in the ward for the first 24 hours after admission.
Methods: A total number of 424 patients were included in the study with GCS of 15, 14 and
13. The scores were strengthened by the presence or absence of neurological symptoms like;
loss of consciousness, headache, pupillary dilatation, seizures and vomiting. The patients were
followed up in the ward and progress was noted. After completion of 24 hours, final remarks
of the outcome were noted. The target was three outcomes: 1.Good recovery where patients
discharged home 2.Fair or no changes and patients needed more observations 3.Poor progress
as the patients were deteriorating.
Also influence of long bone fractures on neurological outcomes were determined.
Results: Sixty three (14.8%) patients deteriorated, 88(20.7%) patients needed more
observation and brain CT scan were inquired, 270(63.4%) recovered well and discharged on
instructions of primonitory signs of impending neurological deterioration while 3(0.7%) died.
The findings were statistically significant (P=000). Subdural hematoma was the leading cause
of deterioration 23(39.7%) while normal CT Scan was found in 8(13.8%) patients despite of
their deterioration. Presence of long bone fractures concomitantly with mild TBI has a
significant role in neurological deterioration (P=0.043).
Conclusion: Inspite of a good score during admission of mild traumatic brain injured patients
and high expectations of immediate recovery, still there is a significant possibilities of some
of these patients deteriorating. Close monitoring and aggressive intervention measures are
needed for the best outcome of patients.
