Traumatic brain injury: Association between the Glasgow Coma Scale score and intensive care unit mortality
Background. Traumatic brain injury (TBI) prevalence in Botswana is high and this, coupled with a small population, may reduce productivity. There is no previous study in Botswana on the association between mortality from TBI and the Glasgow Coma Scale (GCS) score although global literature supports...
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| Format: | Article |
| Language: | English |
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South African Medical Association
2022-08-01
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| Series: | Southern African Journal of Critical Care |
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| Online Access: | https://samajournals.co.za/index.php/sajcc/article/view/109 |
| _version_ | 1797328380918497280 |
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| author | J J Mkubwa A G Bedada T M |
| author_facet | J J Mkubwa A G Bedada T M |
| author_sort | J J Mkubwa |
| collection | DOAJ |
| description | Background. Traumatic brain injury (TBI) prevalence in Botswana is high and this, coupled with a small population, may reduce productivity. There is no previous study in Botswana on the association between mortality from TBI and the Glasgow Coma Scale (GCS) score although global literature supports its existence.
Objectives. Our primary aim was to determine the association between the initial GCS score and the time to mortality of adults admitted with TBI at the Princess Marina Hospital, Gaborone, Botswana, between 2014 and 2019. Secondary aims were to assess the risk factors associated with time to mortality and to estimate the mortality rate from TBI.
Methods. This was a retrospective cohort design, medical record census conducted from 1 January 2014 to 31 December 2019.
Results. In total, 137 participants fulfilled the inclusion criteria, and the majority, 114 (83.2%), were male with a mean age of 34.5 years. The initial GCS score and time to mortality were associated (adjusted hazard ratio (aHR) 0.69; 95% confidence interval (CI) 0.508 - 0.947). Other factors associated with time to mortality included constricted pupil (aHR 0.12; 95% CI 0.044 - 0.344), temperature (aHR 0.82; 95% CI 0.727 - 0.929), and subdural haematoma (aHR 3.41; 95% CI 1.819 - 6.517). Most cases of TBI (74 (54%)) were due to road traffic accidents. The number of deaths was 48 (35% (95% CI 27.1% - 43.6%)), entirely due to severe TBI.
Conclusion. The study confirmed significant association between GCS and mortality. Males were mainly involved in TBI. These findings lack external validity because of the small sample size, and therefore a larger multicentre study is required for validation. |
| first_indexed | 2024-03-08T06:52:01Z |
| format | Article |
| id | doaj.art-5e31c42bbf2740a681f0542815093272 |
| institution | Directory Open Access Journal |
| issn | 1562-8264 2078-676X |
| language | English |
| last_indexed | 2024-03-08T06:52:01Z |
| publishDate | 2022-08-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | Southern African Journal of Critical Care |
| spelling | doaj.art-5e31c42bbf2740a681f05428150932722024-02-03T06:49:59ZengSouth African Medical AssociationSouthern African Journal of Critical Care1562-82642078-676X2022-08-01606310.7196/SAJCC.2022.v38i2.525113Traumatic brain injury: Association between the Glasgow Coma Scale score and intensive care unit mortalityJ J Mkubwa0A G Bedada1T M2Department of Anaesthesia and Critical Care, Princess Marina Hospital, Ministry of Health and Wellness, Gaborone, BotswanaDepartment of Surgery, Faculty of Medicine, University of Botswana, and Princess Marina Hospital, Gaborone, BotswanaDivision of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South AfricaBackground. Traumatic brain injury (TBI) prevalence in Botswana is high and this, coupled with a small population, may reduce productivity. There is no previous study in Botswana on the association between mortality from TBI and the Glasgow Coma Scale (GCS) score although global literature supports its existence. Objectives. Our primary aim was to determine the association between the initial GCS score and the time to mortality of adults admitted with TBI at the Princess Marina Hospital, Gaborone, Botswana, between 2014 and 2019. Secondary aims were to assess the risk factors associated with time to mortality and to estimate the mortality rate from TBI. Methods. This was a retrospective cohort design, medical record census conducted from 1 January 2014 to 31 December 2019. Results. In total, 137 participants fulfilled the inclusion criteria, and the majority, 114 (83.2%), were male with a mean age of 34.5 years. The initial GCS score and time to mortality were associated (adjusted hazard ratio (aHR) 0.69; 95% confidence interval (CI) 0.508 - 0.947). Other factors associated with time to mortality included constricted pupil (aHR 0.12; 95% CI 0.044 - 0.344), temperature (aHR 0.82; 95% CI 0.727 - 0.929), and subdural haematoma (aHR 3.41; 95% CI 1.819 - 6.517). Most cases of TBI (74 (54%)) were due to road traffic accidents. The number of deaths was 48 (35% (95% CI 27.1% - 43.6%)), entirely due to severe TBI. Conclusion. The study confirmed significant association between GCS and mortality. Males were mainly involved in TBI. These findings lack external validity because of the small sample size, and therefore a larger multicentre study is required for validation.https://samajournals.co.za/index.php/sajcc/article/view/109mortalityicugcsstraumatic brain injury |
| spellingShingle | J J Mkubwa A G Bedada T M Traumatic brain injury: Association between the Glasgow Coma Scale score and intensive care unit mortality Southern African Journal of Critical Care mortality icu gcss traumatic brain injury |
| title | Traumatic brain injury: Association between the Glasgow Coma Scale score and intensive care unit mortality |
| title_full | Traumatic brain injury: Association between the Glasgow Coma Scale score and intensive care unit mortality |
| title_fullStr | Traumatic brain injury: Association between the Glasgow Coma Scale score and intensive care unit mortality |
| title_full_unstemmed | Traumatic brain injury: Association between the Glasgow Coma Scale score and intensive care unit mortality |
| title_short | Traumatic brain injury: Association between the Glasgow Coma Scale score and intensive care unit mortality |
| title_sort | traumatic brain injury association between the glasgow coma scale score and intensive care unit mortality |
| topic | mortality icu gcss traumatic brain injury |
| url | https://samajournals.co.za/index.php/sajcc/article/view/109 |
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