Epidemiology and Prehospital Characteristics of Traumatic Brain Injury Patients Requiring Emergency Surgical Intervention: Survey from a Level I Neuro-Trauma Care Center.

BACKGROUND

Traumatic brain injuries (TBI) pose a major public health challenge to the Indian health system. The trajectory of patients from the site of injury to definitive management needs to be understood to improve prehospital management.

OBJECTIVE

We conducted a prospective survey to review the epidemiological and pre-hospital characteristics of TBI patients requiring emergency surgical intervention at a level I neuro-trauma care center.

METHODS AND MATERIALS: Patients who underwent emergency neurosurgical management for TBI at the National Institute of Mental Health and Neurosciences (NIMHANS, Bangalore) between June 2021 and December 2021 were included in the study.

RESULTS

A total of 214 patients were included in the study (86% males). The most common cause of TBI was road traffic accidents (70%) which involved a motorized two-wheeler in 87% of the cases. No safety gear was used in 87% of the road traffic accidents. The median delay in first contact with any medical facility was 60 min. The median time of seeking care at NIMHANS was 6 h and 50 min after the injury. More than one-third of the patients had visited two or more health facilities before reaching NIMHANS for treatment.

CONCLUSION

Road traffic accidents without safety gear constitute the major cause of TBIs requiring emergency surgery. A major challenge exists in prehospital care and organized hospital transfer of acute TBI patients requiring emergency surgery.