Profile of Head Injuries: Pre hospital Care, Diagnosis and Severity in an Ethiopian Tertiary Hospital.

BACKGROUND: Consistent data on head injury is lacking especially in the low and middle income countries. Our study tries to characterize head injury patients at the emergency room of one of the few tertiary public hospitals giving neurosurgical care in the country.

METHODS: A retrospective cross sectional study done from May 2015 -October 2015 in one of the neurosurgical teaching hospitals, Black Lion Specialized Hospital. All adult head injury patients who visited the emergency department during the study period were included. Data on patients' sociodemographic, mechanism of trauma, clinical presentation, imaging findings and presence of poly trauma were collected by a pretested questionnaire. The source of data was ER logbooks and patient charts.

RESULTS: A total of 390 head injury patients who visited the ER were collected during the study period. There were 335(85.9%) males and 55(14.1%) females with mean age (SD) of 35.4(15.6) years. Majority of patients came by taxi constituting 149(38.2%) of all patients while 147 (37.7%) patients used ambulance. Out of 147 patients brought by ambulances, 133(90.4%) of them came referred from other hospitals. The majority, 26(45.6%), of patients who came directly to the ER used taxis. It is shown that mode of arrival and origin of arrival are significantly related, p=0.000.Mortality of severe head injury at the ER was 50.8%.

CONCLUSION: Prehospital care coverage was low and ambulances were used mainly for inter hospital transfers. Mortality of severe head injury at the emergency department is high and significantly associated with preventable causes like vital sign derangement.