Clinical Management and Outcomes of Traumatic Brain Injury: A Comparative Study of High-Resource and Low-Resource Hospital Settings.”
DOI:
https://doi.org/10.36552/pjns.v29i1.1066Keywords:
CT: Computed Tomography, Head injury, Road traffic accidentAbstract
To compare management strategies and outcomes of TBI in high-resource versus low-resource hospital settings.
Methodology:
This multicenter, prospective observational study included all patients with traumatic brain injury. Data was collected using a standardized questionnaire that included demographics, medical history, injury details, GCS scores and GOSE outcomes. A brain CT scan was performed within 24 hours of injury, and follow-up assessments were conducted at two weeks. Statistical analysis was performed using SPSS version 27, with chi-square test and logistic regression used to assess associations between variables and hospitals.
Results:
Among 124 traumatic brain injury patients, 74% were males with mean age of 41.63 +/- 15.39; and 40.3% aged between 31–50 years, equally distributed between low- and high-resource hospitals. Road traffic accidents caused 75% of injuries, with 39.5% classified as severe TBI. Surgical interventions were performed more frequently in high-resource settings (22.6% vs. 4.8%). Majority of low-resource patients (82.3%) had hospital stays ?3 days compared to 48.4% in high-resource hospitals. At two weeks, unfavorable outcomes (GOSE) were more common in low-resource hospitals (41.9% vs. 33.9%). Co-morbidities increased the likelihood of unfavorable outcomes (OR = 10.868, p = 0.066), as did peripheral injuries (OR = 1.332, p = 0.708). Mild (OR = 0.002, p < 0.001) and moderate (OR = 0.024, p < 0.001) TBI significantly reduced the risk of unfavorable outcomes compared to severe TBI.
Conclusion:
In high-resource settings, a larger proportion of patients experienced severe traumatic brain injuries, underwent surgical interventions, had longer hospital stays and showed relatively better recovery outcomes.
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Copyright (c) 2025 Saba Zaidi, Attiya Sabeen Rahman, Almas Zafar, Haneea Yasir, Saad AkhterThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
