Evidence map›Paper›PMID 37880635›Full record

ArticleBMC surgery2023

Burden, risk factors, neurosurgical evacuation outcomes, and predictors of mortality among traumatic brain injury patients with expansive intracranial hematomas in Uganda: a mixed methods study design.

Larrey Kasereka Kamabu, Godfrey S Bbosa, Hervé Monka Lekuya, Eugene J Cho, Victor Meza Kyaruzi, Arsene Daniel Nyalundja, Daniel Deng, Juliet Nalwanga Sekabunga, Louange Maha Kataka, Doomwin Oscar Deogratius Obiga and 5 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 5 countries.

Larrey Kasereka KamabuDepartment of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda. kamabularry@gmail.com.
Godfrey S BbosaDepartment of Pharmacology & Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda.
Hervé Monka LekuyaDepartment of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda.
Eugene J ChoDuke University, Durham, NC, USA.
Victor Meza KyaruziDepartment of Surgery, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Arsene Daniel NyalundjaFaculty of Medicine, Université Catholique de Bukavu, Bukavu, South Kivu, Democratic Republic of the Congo.
Daniel DengDuke Global Neurosurgery, Neurology and Health System, Duke University, Durham, NC, USA.
Juliet Nalwanga SekabungaDepartment of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda.
Louange Maha KatakaFaculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo.
Doomwin Oscar Deogratius ObigaDepartment of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda.
Joel KiryabwireDepartment of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda.
Martin N KaddumukasaDepartment of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
Mark KaddumukasaDepartment of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
Anthony T FullerDuke University, Durham, NC, USA.
Moses GalukandeDepartment of Surgery, Neurosurgery, College of Medicine, Makerere University, Kampala, Uganda.
Makerere University · UGMulago Hospital · UGDuke University · USDuke University Health System · USMuhimbili University of Health and Allied Sciences · TZUniversité Catholique de Bukavu · CDUniversité Catholique du Graben · CD

Funding

Research training and mentorship to strengthen brain health across the lifespan in Uganda.D43NS118560 · NINDS · MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI KADDUMUKASA, MARK, KATABIRA, ELLY T · 2020 to 2024
$1.1M
NINDS NIH HHS D43 NS118560
6 · The paper itself

Abstract

backgroundExpansive intracranial hematomas (EIH) following traumatic brain injury (TBI) continue to be a public health problem in Uganda. Data is limited regarding the neurosurgical outcomes of TBI patients. This study investigated the neurosurgical outcomes and associated risk factors of EIH among TBI patients at Mulago National Referral Hospital (MNRH).

methodsA total of 324 subjects were enrolled using a prospective cohort study. Socio-demographic, risk factors and complications were collected using a study questionnaire. Study participants were followed up for 180 days. Univariate, multivariable, Cox regression analyses, Kaplan Meir survival curves, and log rank tests were sequentially conducted. P-values of < 0.05 at 95% Confidence interval (CI) were considered to be statistically significant.

resultsOf the 324 patients with intracranial hematomas, 80.6% were male. The mean age of the study participants was 37.5 ± 17.4 years. Prevalence of EIH was 59.3% (0.59 (95% CI: 0.54 to 0.65)). Participants who were aged 39 years and above; PR = 1.54 (95% CI: 1.20 to 1.97; P = 0.001), and those who smoke PR = 1.21 (95% CI: 1.00 to 1.47; P = 0.048), and presence of swirl sign PR = 2.26 (95% CI: 1.29 to 3.95; P = 0.004) were found to be at higher risk for EIH. Kaplan Meier survival curve indicated that mortality at the 16-month follow-up was 53.4% (95% CI: 28.1 to 85.0). Multivariate Cox regression indicated that the predictors of mortality were old age, MAP above 95 mmHg, low GCS, complications such as infection, spasticity, wound dehiscence, CSF leaks, having GOS < 3, QoLIBRI < 50, SDH, contusion, and EIH.

conclusionEIH is common in Uganda following RTA with an occurrence of 59.3% and a 16-month higher mortality rate. An increased age above 39 years, smoking, having severe systemic disease, and the presence of swirl sign are independent risk factors. Old age, MAP above 95 mmHg, low GCS, complications such as infection, spasticity, wound dehiscence, CSF leaks, having a GOS < 3, QoLIBRI < 50, ASDH, and contusion are predictors of mortality. These findings imply that all patients with intracranial hematomas (IH) need to be monitored closely and a repeat CT scan to be done within a specific period following their initial CT scan. We recommend the development of a protocol for specific surgical and medical interventions that can be implemented for patients at moderate and severe risk for EIH.

Indexed as

Brain Injuries, TraumaticContusionsAdultFemaleGlasgow Coma ScaleHematomaHumansMaleMiddle AgedPostoperative ComplicationsProspective StudiesRisk FactorsUgandaYoung AdultAnd predictors of mortalityBurdenNeurosurgical outcomesRisk factorsTraumatic expansive intracranial hematomas

Identifiers

PMID37880635
PMCPMC10601114
OpenAlexW4387937541

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.