The CDC has termed traumatic brain injury (TBI) as the “silent epidemic” of developed nations. WHO states, by 2020 TBIs will be third largest killer in the developing world. In India Road traffic accidents (RTAs) accounts for 45-60% of TBIs. Karnataka is ranked the fourth highest in the total number of RTAs in the country.
Objectives: To study the clinic-epidemiological profile and determinants of outcome of TBI patients.
Methodology: A retrospective case series study was conducted in the setting of Neurosurgery department where data from all TBIs admitted from January 2011 to December 2015 were analyzed based on age, sex, GCS score, mechanism and severity of injury, concurrent injuries, CT scan results, type of management and outcome.
Results: Among 5092 patients studied, the majority were aged 15 - 45years (68%) and males (82.6%). RTAs (74%) were the leading cause and 63% of had mild, 16% had moderate and 21% had severe head injury. 16% of TBIs were associated with other injuries, majority of which include chest and abdomen injuries and lower limb long bone fractures. Skull bone fractures, acute subdural, intarcerebral and extradural hemorrhages were the most common CT findings. 13.2% of the patients were managed surgically. The overall mortality in our series was 15% and the factors associated with increased mortality are elderly age, poor presenting GCS, associated thoraco abdominal injuries, lower limb and pelvic fracture, multiple bleed, diffuse axonal injury, diffuse subarachnoid hemorrhage, bleed involving more than one cranial fosse, occipital bleed and counter-coup injuries.
Conclusions: RTAs are the leading cause of TBIs in Karnataka affecting mainly young adult males. Overall mortality of TBI patients was 15%.