Review of adult head injury admissions into the intensive care unit of a tertiary hospital in Nigeria|
Owojuyigbe, Afolabi M.; Komolafe, Edward O.; Dada, Olumuyiwa A.; Dada, Olufunke F.; Adenekan, Anthony T.; Faponle, Aramide F.; Ogunbameru, Ibironke O.; Owagbemi, Oluwafemi F.; Ige-Orhionkpaibima, Fred S.; Onyia, Chiazor U. & Olanrewaju, Oluseun A.
Background: Head injury is frequently associated with death and disability and imposes
considerable demands on health services. Outcome after head injury is closely related to
prompt management, including prevention of secondary brain injury and intensive care unit
(ICU) management. This study aimed at determining the aetiological spectrum, injury
characteristics, ICU admission patterns, and treatment outcomes of adult head-injured
patients at a sub-Saharan tertiary hospital.
Methods: A retrospective study on adult head-injured patients admitted to the ICU of a sub-Saharan tertiary hospital between July 2000 and June 2010.
Results: A total of 198 head-injured adult patients were managed in the ICU during the study
period. This included 128 males and 70 females with a male-to-female ratio of 1.8:1. The most
common mode of injury was road traffic accident. All the patients admitted to ICU had either
moderate or severe head injury, with 73.7% having severe head injury. About 26.3% of the
patients had associated cervical spine injuries and 50% had various musculoskeletal and
soft tissue injuries. Cranial computed tomography findings included brain contusions and
intracranial haematomas. Mean duration of ICU stay was 18 days (range 24 hours-42 days),
with 89.9% discharged out of ICU care. The overall mortality was 10.1%, although only
36.9% had satisfactory outcomes, as determined by the Glasgow Outcome Scale. Outcome
had statistically significant (P < 0.05) relationship with severity of head injury and surgical
Conclusions: Head injury management in the ICU requires an approach to ensure prevention
of secondary brain injury; appropriate and early neuroimaging to diagnose lesions that
would benefit from timely surgical intervention; as well as management of fluid, electrolyte
and haematological derangements.
head injury; admissions; ICU