ArticlePloS one2020
An analysis of emergency care delays experienced by traumatic brain injury patients presenting to a regional referral hospital in a low-income country.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Prehospital Emergency Care in Low- and Middle-Income Countries: A Systematic Review.Prehospital and disaster medicine · 2023Pooled it
- Resource use, availability and cost in the provision of critical care in Tanzania: a systematic review.BMJ open · 2022Pooled it
- Emergency triage in coastal Kenya: a survey of public Emergency Departments.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Penetrating maxillofacial trauma with transmaxillary migration of a metallic foreign body to the sphenoid sinus: A rare case.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- Long-Term Mortality and Quality of Life Among Adults With Mild Traumatic Brain Injury.JAMA network open · 2026Article
- Impact of Initial Care at a Neurosurgery-Capable Facility on Mortality Among Patients with Moderate-to-Severe Traumatic Brain Injury in South Africa.Neurocritical care · 2026Article
- Predicting Outcomes of Traumatic Brain Injury Using Machine Learning Models Among Patients at Kilimanjaro Christian Medical Centre, Tanzania: A Registry-Based Cohort Study.Health science reports · 2026Article
- A Decision Tree Cost Analysis of Intracranial Bleed Detection Using a Near-Infrared Device Across Various Healthcare Levels.Journal of market access & health policy · 2026Article
- Time-critical care gaps and systemic delays linked to higher mortality in severe trauma patients in Tanzania.BMC emergency medicine · 2026Observational
- Assessment of neurosurgical workforce, infrastructure, and service delivery capacity in East Africa: A collaborative survey.Neurosurgical review · 2025Article
- Navigating Limitations and Clinical Challenges in Indonesian Tertiary Trauma Center for Penetrating Brain Injury: A Case Report and Literature Review.Asian journal of neurosurgery · 2025Article
- Agricultural Farm-Related Head Injuries in Rural India: A Case Series.Korean journal of neurotrauma · 2025Article
- The older the injured, the worse the outcomes: A comparison of injury patterns and in-hospital outcomes between younger and older adult trauma patients at a tertiary hospital in Northern Tanzania.PLOS global public health · 2025Article
- Article
- Head injuries in prehospital and Emergency Department settings: a prospective multicenter cross-sectional study in France.BMC emergency medicine · 2024Article
- Barriers and facilitators when seeking healthcare for septic children in Ghana: a single-centre qualitative study of patient caregivers and emergency department clinicians.BMJ paediatrics open · 2024Article
- Pre-hospital care, pre-hospital delay, and in-hospital delay in patients with traumatic brain injury in getting neurosurgical care in a tertiary care center: A Cross-Sectional study.JNMA; journal of the Nepal Medical Association · 2024Article
- Access to quality care after injury in Northern Malawi: results of a household survey.BMC health services research · 2024Article
- Outcomes of traumatic brain injury patients with acute epidural and subdural hematoma who underwent burr hole surgery: A two-year study at Kilimanjaro Christian Medical Centre, Tanzania.World neurosurgery: X · 2024Article
- Challenges in traumatic spinal cord injury care in developing countries - a scoping review.Frontiers in public health · 2024Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundTrauma is a leading cause of death and disability worldwide. In low- and middle-income countries (LMICs), trauma patients have a higher risk of experiencing delays to care due to limited hospital resources and difficulties in reaching a health facility. Reducing delays to care is an effective method for improving trauma outcomes. However, few studies have investigated the variety of care delays experienced by trauma patients in LMICs. The objective of this study was to describe the prevalence of pre- and in-hospital delays to care, and their association with poor outcomes among trauma patients in a low-income setting.
methodsWe used a prospective traumatic brain injury (TBI) registry from Kilimanjaro Christian Medical Center in Moshi, Tanzania to model nine unique delays to care. Multiple regression was used to identify delays significantly associated with poor in-hospital outcomes.
resultsOur analysis included 3209 TBI patients. The most common delay from injury occurrence to hospital arrival was 1.1 to 4.0 hours (31.9%). Most patients were evaluated by a physician within 15.0 minutes of arrival (69.2%). Nearly all severely injured patients needed and did not receive a brain computed tomography scan (95.0%). A majority of severely injured patients needed and did not receive oxygen (80.8%). Predictors of a poor outcome included delays to lab tests, fluids, oxygen, and non-TBI surgery.
conclusionsTime to care data is informative, easy to collect, and available in any setting. Our time to care data revealed significant constraints to non-personnel related hospital resources. Severely injured patients with the greatest need for care lacked access to medical imaging, oxygen, and surgery. Insights from our study and future studies will help optimize resource allocation in low-income hospitals thereby reducing delays to care and improving trauma outcomes in LMICs.
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Registered trials
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