Admissions and Outcomes of Intensive Care Management of Severe Head Injured Patients in Non-Neurosurgical Centres
International Journal of Anesthesia and Clinical Medicine
Volume 2, Issue 2, March 2014, Pages: 18-21
Received: Apr. 27, 2014;
Accepted: May 15, 2014;
Published: May 30, 2014
Views 2708 Downloads 132
Abubakar Sadiq Adamu, Department of Anaesthesia and Intensive Care, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
Abubakar Alhaji Bakari, Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
Usman Mohammed Tela, Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
Babayo Deba Usman, Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
Yusuf Bukar Ngamdu, Department of Ear, Nose and Throat (ENT), University of Maiduguri Teaching Hospital, Maiduguri, Borno state, Nigeria
Sambo Tanimu Yusuf, Department of Anaesthesia, Federal Teaching Hospital, Gombe, Gombe state, Nigeria
Follow on us
Background: The admissions and outcomes of intensive care management of severe head injured patients depend not only on the standard and effectiveness of the treatment obtained but also on the available technical and human resources. We aimed at auditing the admissions and indeed the outcomes of severe head injured patients admitted in our non-neurosurogical centres. Patients and Methods: This was a retrospective review of the demographic, clinical with neurological data and outcomes of the management of all severely head injured patients admitted to the Intensive Care Units (ICU) of the Federal Teaching Hospital, Gombe and University of Maiduguri Teaching Hospital, Nigeria, for three year duration from January, 2007- December, 2009. Results: The total of 258 cases were retrieved and analyzed within the period under review. Two hundred and thirty one (n=231, 89.53%) were males and twenty seven (n=27, 10.47%) were females. The ages ranges between 1-70 years old with the mean ages of 31.29 (SD=15.66). The length of stay (LOS) from admission to discharge ranged from 1-29 days with the mean of 5.80 days (SD= 6.06) while, the LOS from admission to death ranged from 1-24 days with the mean of 3.62days (SD=4.14). Majority (91.8%) of the causes of the head injury were due to RTA with the mortality rates of 27.9%. Conclusions: A well equipped ICU would greatly facilitate the care of the severely head injured patients and can be an achievable goal in developing countries, if there is rational allocation of resources despite the prevailing challenges. We therefore, recommend the establishment of ICU in general and to encourage physicians to develop interest in the management of severely head injured patients even in a non-neurosurgical ICU.
Admissions, Outcomes, Severe Head Injury, Management, Non-Surgical ICU
To cite this article
Abubakar Sadiq Adamu,
Abubakar Alhaji Bakari,
Usman Mohammed Tela,
Babayo Deba Usman,
Yusuf Bukar Ngamdu,
Sambo Tanimu Yusuf,
Admissions and Outcomes of Intensive Care Management of Severe Head Injured Patients in Non-Neurosurgical Centres, International Journal of Anesthesia and Clinical Medicine.
Vol. 2, No. 2,
2014, pp. 18-21.
Bullock R, Chestnut RM, Clifton G, Ghajar J, Marion DW, et al: Guideline for the management of severe head injury. J Neurotrauma 1996, 13(1): 643-734.
Bullock R, Chestnut RM, Clifton G, Ghajar J, Marion DW, et al: Guidelines for the management of Severe Traumatic Injury. J Neurotrauma 2000, 17: 453-553.
Bullock R.: Guidelines for the management of severe Traumatic Brain injury. J Neurotrauma, 2007, 1: S1-106.
Vukic M, Negovetic L, Kovac D, Ghajar J, Glavic Z: The effect of implementation of guidelines for the management of severe head injury on patient treatment and outcomes. Acta Neurochir (Wien) 1996, 141(11): 203-8.
Hesdorffer D, Ghajar J, Lacono L: Predictors of compliance with the evidence-based guidelines for traumatic brain injury care: A survey of United States Trauma centers. J Trauma 2002, 52: 1202-1209.
Chestnut RM: Secondary brain insults after head injury: clinical perspectives. New Horiz 1995, 3: 366-75.
Unterberg AW, Stover IF, Kress B, Kiening KI: Edema and brain trauma. Neuroscience 2004, 129: 1021-9.
Saul TG, Ducker TB: Intracranial pressure monitoring in patients with severe head injury. AM Surg 1982, 48(9): 477-480.
Young M, Birkmeyer JD. Potential reduction in mortality rates using an intensivist model to manage intensive care units. Eff Clin Pract 2000; 3: 284-289.
Girling K. Management of head injury in the intensive care unit. Continuing Education in Anaesthesia, Critical Care and Pain. 2004; 4: 52-56.
Marik P, Varon J, Trash T. Management of head trauma. Chest 2002; 122: 699-711.
Adamu AS, Ojo E, El-Nafaty A, Edomwonyi N: An Audit of one-year Intensive Care practice in a developing country. The internet Journal of Anesthesiology. 2008 volume 18(2): DOI: 5580/25b2.
The Brain Trauma Foundation. The American Association of Neurological Surgeons. The joint Section on Neurotrauma and Critical Care; Indications for intracranial pressure monitoring. J Neurotrauma 2000; 17: 479-491.
Maas AIR, Dearden M, Teasdale GM, Braakman R, Cohadon F, et al : European Brain Injury Consortium: EBIC-Guidelines for management of severe head injury in adults. Acta Neurochir 1997; 139: 286-294.
Cremer OL, van Dijk GW, van Wenser E, Brekelmans GJ, Moons KG et al. Effects of intracranial pressure monitoring and targeted intensive care on functional outcomes after severe head injury. Crit Care Med 2005; 33: 2207-2213.
Shehu BB. Practical management of head injury. Annals of African Medicine 2002; 1(1): 8-17.
LIN SC. Managing change in critical medicine. Int J Intensive Care 2001; 8: 193-228.