Epidemiology of head injury in South-West Nigeria: a retrospective cohort from a non-neurosurgical trauma centre.

PURPOSE: Specialist neurosurgical services are not readily available in all tertiary hospitals in Nigeria. Very little is known about the current state of management of head-injury (HI) patients in non-neurosurgical centres. This study evaluates the epidemiology and management outcomes of HI patients in a non-neurosurgical centre in South-West Nigeria. We also highlighted gaps in care and provided recommendations. METHOD: A 5-year retrospective analysis of patients with head injuries was conducted. Relevant demographic, clinical and outcome data were retrieved and analysed.

RESULTS

Three hundred and forty-seven patients were included in this study. There were 262 males, with a male-female ratio of 3:1. The most affected age group was 30–39 years, and the majority (72.3%) had mild HI. One hundred and sixty (46.1%) patients presented within the first hour of injury. Only 11 (3.2%) patients were brought to the emergency department by ambulance. There was a significant association between age groups and injury mechanism (p = 0.000), with a predominance of motorcycle accidents. The post-resuscitation GCS was the only significant independent predictor of survival (OR = 0.48, 95% CI: 0.34–0.68, p = 0.000). The mortality rate was 4.3%, including six patients who died en route to a neurosurgical centre.

CONCLUSION

Head injury mainly affected young males and was motorcycle-related, with most cases mild and few transported by ambulance. Deaths occurred in severe cases and during transfer, underscoring gaps in prehospital care and referral systems and the need to strengthen non-neurosurgical centres.