Clinical characteristics and treatment outcomes among traumatic head injury patients at Embu Level Five Hospital in Kenya

Rebecca Wambui Kahihu; Alfred Owino Odongo; Josephat Njuguna

doi:10.51867/ajernet.7.2.118

Autores

Rebecca Wambui Kahihu Mount Kenya University, Kenya https://orcid.org/0009-0008-8729-2830
Alfred Owino Odongo Mount Kenya University, Kenya https://orcid.org/0000-0002-4138-2434
Josephat Njuguna Mount Kenya University, Kenya

DOI:

https://doi.org/10.51867/ajernet.7.2.118

Palavras-chave:

Clinical Characteristics, Emergency Triage, Glasgow Coma Scale, Neuroimaging Deficits, Resource Constrained Environment, Traumatic Head Injury, Treatment Outcomes

Resumo

Traumatic head injury (THI) is a major cause of death and disability worldwide, especially in resource-limited areas where more sophisticated diagnostics are not available. Empirical data from local clinical settings on the effect of clinical features on THI treatment outcome in Kenyan regional hospitals is still limited. To analyse the association between clinical characteristics and treatment outcome of patients with traumatic head injury at Embu Level 5 Hospital, Kenya. This study was guided by the three-delay model. A descriptive cross-sectional hospital-based study was conducted using a simple random sampling technique of 240 THI patients out of a total population of 600 patients who were treated from July 2022 to June 2023. IBM SPSS Version 27 was used to analyse the data that was extracted from patient medical records. Chi-square test and Pearson's correlation coefficients were used to analyse the relationship between clinical parameters and treatment outcome. Results: 46.4% of the study cohort were mild, 33.9% were moderate and 19.7% were severe THI. There was a significant relationship between severity of injury and longer hospital stays (p < .001). The Glasgow Coma Scale (GCS) scores showed a strong positive correlation with clinical diagnosis (r = .65, p < .001), with 10.8% of the patients having severe neurological impairment (GCS < 8). The proportion of patients who were maintaining oxygen saturation > 90% was suboptimal at 50.2%, with 34.3% of vital sign data not available at all. In addition, a significant lack of documentation of computed tomography (CT) scans was found, with 51.9% of patients not having a documented CT scan. It can be concluded that low GCS scores and physiological instability at presentation are the most important factors associated with poor treatment outcomes. Major systemic challenges, such as delays in accessing neuroimaging and inconsistent recording of vital signs, greatly impact clinical decision-making and continuous patient monitoring. The study recommends that the hospital should improve its initial triage system to quickly recognise high-risk patients, ensure continuous uniform monitoring of vital parameters, and streamline referral pathways to tertiary neurosurgical centres to minimise delays and maximise survival.

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Biografias do Autor

Alfred Owino Odongo, Mount Kenya University, Kenya

School of Public Health
Josephat Njuguna, Mount Kenya University, Kenya

School of Medicine

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