O202: Clinical characteristics and outcomes of traumatic brain injury in a high-volume tertiary hospital in India

Abstract

Abstract Background Traumatic brain injury (TBI) is a common neurosurgical emergency but its epidemiological and clinical characteristics vary across country income levels. High-quality TBI data from low and lower-middle income countries are required to inform trials and public policy in these settings. Methods We performed a prospective cohort study of patients admitted to a high-volume tertiary hospital in Vellore, India following a TBI between 2013 and 2019. We collected data on patient characteristics and measured their outcomes using the Glasgow Outcome Scale-Extended (GOSE). Results We identified 3,172 patients (84% males) with a mean age of 35 years (SD = 18). Two-wheeler road traffic accidents caused 2,259/3,172 (71%) injuries, in which 13 (0.5%) patients were wearing a helmet. The median time from injury to admission was 3 hours (IQR = 2–7). 2,363/3,172 (75%) patients did not undergo surgery and 405/3,172 (13%) underwent decompressive craniectomy and haematoma evacuation. Inpatient mortality was 5.6% (median length of stay = 6 days [IQR = 4–10]) and overall mortality at discharge from follow-up (median = 6 months [IQR = 3–9]) was 18%. Inpatient deaths most frequently occurred within two days of admission (82/174 [47%]). 2,066/3,082 (67%) patients had upper- or lower-good recovery. The IMPACT (AUC = 83%, CI: 79–87%) and Rotterdam CT prognostic scores (AUC = 79%, CI: 75–83%) predicted inpatient mortality with good performance. Conclusions We describe the TBI population of a high-volume tertiary hospital in India, including inpatient mortality, medium-term functional status, and the performance of commonly used prognostic tools.