Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series
Abstract Introduction Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-10-01
|
| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-021-00504-5 |
| _version_ | 1818368059453210624 |
|---|---|
| author | Paterne Safari Mudekereza Gauthier Bahizire Murhula Charles Kachungunu Amani Mudekereza Fabrice Cikomola Leon-Emmanuel Mukengeshai Mubenga Patrick Birindwa Balungwe Paul Munguakonkwa Budema Christian Molima Erick Namegabe Mugabo Hervé Monka Lekuya |
| author_facet | Paterne Safari Mudekereza Gauthier Bahizire Murhula Charles Kachungunu Amani Mudekereza Fabrice Cikomola Leon-Emmanuel Mukengeshai Mubenga Patrick Birindwa Balungwe Paul Munguakonkwa Budema Christian Molima Erick Namegabe Mugabo Hervé Monka Lekuya |
| author_sort | Paterne Safari Mudekereza |
| collection | DOAJ |
| description | Abstract Introduction Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilians and military are frequently assaulted on the head, but paradoxically their hospital outcomes are under-reported. We aimed to identify factors associated with poor hospital outcomes of patients with PCCI. Methods This was a retrospective series of patients admitted at the Regional Hospital of Bukavu, DRC, from 2010 to 2020. We retrieved medical records of patients with PCCI operated in the surgical departments. A multivariate logistic regression model was performed to find associations between patients’ admission clinico-radiological parameters and hospital outcomes. Poor outcome was defined as a Glasgow Outcomes Score below 4. Results The prevalence of PCCI was 9.1% (91/858 cases) among admitted TBI patients. More than one-third (36.2%) of patients were admitted with GCS < 13, and 40.6% of them were unstable hemodynamic. Hemiplegia was found in 23.1% on admission. Eight patients had an intracerebral hemorrhage. Among the 69 operated patients, complications, mainly infectious, occurred in half (50.7%) of patients. Poor hospital outcomes were observed in 30.4% and associated with an admission GCS < 13, hemodynamic instability, intracerebral hemorrhage, and hemiplegia (p < 0.05). Conclusion The hospital poor outcomes are observed when patients present with hemodynamic instability, an admission GCS < 13, intracerebral hemorrhage, and hemiplegia. There is a need for optimizing the initial care of patients with PCCI in armed conflict regions. |
| first_indexed | 2024-12-13T23:01:56Z |
| format | Article |
| id | doaj.art-70498c8966fb4a8dadb64de8cb3645fc |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-13T23:01:56Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-70498c8966fb4a8dadb64de8cb3645fc2022-12-21T23:28:23ZengBMCBMC Emergency Medicine1471-227X2021-10-012111910.1186/s12873-021-00504-5Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective seriesPaterne Safari Mudekereza0Gauthier Bahizire Murhula1Charles Kachungunu2Amani Mudekereza3Fabrice Cikomola4Leon-Emmanuel Mukengeshai Mubenga5Patrick Birindwa Balungwe6Paul Munguakonkwa Budema7Christian Molima8Erick Namegabe Mugabo9Hervé Monka Lekuya10Faculté de Médecine, Université Catholique de BukavuFaculté de Médecine, Université Catholique de BukavuSociété Congolaise de Neurochirurgie (SCNC)Hôpital Provincial Général de Référence de BukavuFaculté de Médecine, Université Catholique de BukavuFaculté de Médecine, Université Catholique de BukavuFaculté de Médecine, Université Catholique de BukavuFaculté de Médecine, Université Catholique de BukavuEcole Régionale de Santé Publique, Université Catholique de BukavuHôpital Provincial Général de Référence de BukavuSociété Congolaise de Neurochirurgie (SCNC)Abstract Introduction Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilians and military are frequently assaulted on the head, but paradoxically their hospital outcomes are under-reported. We aimed to identify factors associated with poor hospital outcomes of patients with PCCI. Methods This was a retrospective series of patients admitted at the Regional Hospital of Bukavu, DRC, from 2010 to 2020. We retrieved medical records of patients with PCCI operated in the surgical departments. A multivariate logistic regression model was performed to find associations between patients’ admission clinico-radiological parameters and hospital outcomes. Poor outcome was defined as a Glasgow Outcomes Score below 4. Results The prevalence of PCCI was 9.1% (91/858 cases) among admitted TBI patients. More than one-third (36.2%) of patients were admitted with GCS < 13, and 40.6% of them were unstable hemodynamic. Hemiplegia was found in 23.1% on admission. Eight patients had an intracerebral hemorrhage. Among the 69 operated patients, complications, mainly infectious, occurred in half (50.7%) of patients. Poor hospital outcomes were observed in 30.4% and associated with an admission GCS < 13, hemodynamic instability, intracerebral hemorrhage, and hemiplegia (p < 0.05). Conclusion The hospital poor outcomes are observed when patients present with hemodynamic instability, an admission GCS < 13, intracerebral hemorrhage, and hemiplegia. There is a need for optimizing the initial care of patients with PCCI in armed conflict regions.https://doi.org/10.1186/s12873-021-00504-5Penetrating craniocerebral injuryIntracerebral hemorrhageHemodynamic instabilityHospital outcomesGlasgow outcome score |
| spellingShingle | Paterne Safari Mudekereza Gauthier Bahizire Murhula Charles Kachungunu Amani Mudekereza Fabrice Cikomola Leon-Emmanuel Mukengeshai Mubenga Patrick Birindwa Balungwe Paul Munguakonkwa Budema Christian Molima Erick Namegabe Mugabo Hervé Monka Lekuya Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series BMC Emergency Medicine Penetrating craniocerebral injury Intracerebral hemorrhage Hemodynamic instability Hospital outcomes Glasgow outcome score |
| title | Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series |
| title_full | Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series |
| title_fullStr | Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series |
| title_full_unstemmed | Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series |
| title_short | Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series |
| title_sort | factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the democratic republic of the congo a retrospective series |
| topic | Penetrating craniocerebral injury Intracerebral hemorrhage Hemodynamic instability Hospital outcomes Glasgow outcome score |
| url | https://doi.org/10.1186/s12873-021-00504-5 |
| work_keys_str_mv | AT paternesafarimudekereza factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT gauthierbahiziremurhula factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT charleskachungunu factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT amanimudekereza factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT fabricecikomola factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT leonemmanuelmukengeshaimubenga factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT patrickbirindwabalungwe factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT paulmunguakonkwabudema factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT christianmolima factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT ericknamegabemugabo factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries AT hervemonkalekuya factorsassociatedwithhospitaloutcomesofpatientswithpenetratingcraniocerebralinjuriesinarmedconflictareasofthedemocraticrepublicofthecongoaretrospectiveseries |