Traumatic Brain Injury in the Accident and Emergency Department of a Tertiary Hospital in Nigeria

Background: Traumatic brain injury is a major public health problem in Nigeria, as it could be associated with long term and life long deficits. Unlike other parts of the world, in our country, motorcycles are possibly the main cause of this injury. Unfortunately, we do not have a national epidemiological data base yet. This study was aimed at defining the peculiar demographic and associated risk factors in traumatic brain injury among our patients, as part of a multi-institutional data pool for a future meta-analysis to generate the national data base.
Methods: This was a 24-month retrospective study of all head injury patients who met the criteria for traumatic brain injury in the Accident and Emergency Department of a tertiary health institution. Data were collected from the emergency cards and case notes, then collated and analyzed using the descriptive statistics on SPSS 13, with the p value taken as <0.05.
Results: A total of 9,444 patients were attended to during the 24 months; 510 (5.4%) of them met the inclusion criteria for the study. This translated to a presentation rate of 5.3 cases per week and an incidence rate of 2,710 per 100,000 per year. Males accounted for 404 (79.2%) of the cases. The peak age incidence (31.2%) was in the >20 - 30 year age group. Traders constituted the highest occupational group 125 (24.5%). Most (58.8%) of the cases resulted from motorcycle accident. There were 28 deaths giving a mortality rate of 5.5% or 148 deaths per 100,000 per year.
Conclusion: The risk factors were the male gender, motorcycle riding, illiteracy, trading, extremes of age and active daytime period of 12:01 - 18:00hours. The incidence rate was much higher than in the developed countries, but could reduce with the use of crash helmets, seat belts, speed limits and safety/protective vehicular devices, with better road rehabilitation.