Burden and Patterns of Traumatic Brain Injury in a Tertiary Care Emergency Department in Punjab, Pakistan: A Retrospective Cohort Study

Abstract

Objective:  We examined the burden, mechanisms, and clinical outcomes of TBI in a large tertiary care environment in Punjab, Pakistan, to guide national neurotrauma policy.

Materials & Methods:  The study’s objective was to explore the epidemiological, clinical presentation, and outcomes of patients presenting with traumatic brain injury at Holy Family Hospital. It was a retrospective cohort study that evaluated 561 patients who presented with TBI to the emergency department of a tertiary teaching hospital from February 2024 to February 2025. Demographic, mechanism of injury, and Glasgow Coma Scale (GCS) data were obtained. Severity was categorized as mild (GCS 13–15), moderate (9–12), or severe (3–8). Chi-square and Fisher’s exact tests were used to measure statistical associations.

Results:  The cohort consisted mostly of males (n=448, 79.86 percent) with a mean age of 24.8 ± 21.0 years (range 1–96 years). The age group (2-10 years) was the greatest (n=197, 35.12 percent). The most common cause of injury was road traffic accidents (RTAs) (n=313, 55.79%), and then falls (n=239, 42.60%). The main mechanism in the pediatric population was falls as compared to RTA, which was significantly related to severe TBI (p < 0.001). 

Conclusion:  TBI in Punjab has a bimodal vulnerability, with young children affected by falls and young adults by RTAs. The large percentage of serious injuries requires the adoption of universal triage mechanisms and the inclusion of TBI as a chronic disease into the national health system.