Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series

Introduction Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilian...

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Bibliographic Details
Published in:BMC emergency medicine 2021-10, Vol.21 (1), p.1-109, Article 109
Main Authors: Mudekereza, Paterne Safari, Murhula, Gauthier Bahizire, Kachungunu, Charles, Mudekereza, Amani, Cikomola, Fabrice, Mubenga, Leon-Emmanuel Mukengeshai, Balungwe, Patrick Birindwa, Budema, Paul Munguakonkwa, Molima, Christian, Mugabo, Erick Namegabe, Lekuya, Hervé Monka
Format: Article
Language:English
Subjects:
Analysis
Antibiotics
Complications
Data analysis
Debridement
Demographics
Emergency medical care
Glasgow outcome score
Guided missiles
Head injuries
Hemiplegia
Hemodynamic instability
Hemodynamics
Hemorrhage
Hospital outcomes
Hospitals
Injuries
Intracerebral hemorrhage
Medical records
Missiles
Mortality
Paralysis
Patient outcomes
Patients
Penetrating craniocerebral injury
Rockets (Ordnance)
Trauma
Traumatic brain injury
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Summary:Introduction Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilians and military are frequently assaulted on the head, but paradoxically their hospital outcomes are under-reported. We aimed to identify factors associated with poor hospital outcomes of patients with PCCI. Methods This was a retrospective series of patients admitted at the Regional Hospital of Bukavu, DRC, from 2010 to 2020. We retrieved medical records of patients with PCCI operated in the surgical departments. A multivariate logistic regression model was performed to find associations between patients' admission clinico-radiological parameters and hospital outcomes. Poor outcome was defined as a Glasgow Outcomes Score below 4. Results The prevalence of PCCI was 9.1% (91/858 cases) among admitted TBI patients. More than one-third (36.2%) of patients were admitted with GCS < 13, and 40.6% of them were unstable hemodynamic. Hemiplegia was found in 23.1% on admission. Eight patients had an intracerebral hemorrhage. Among the 69 operated patients, complications, mainly infectious, occurred in half (50.7%) of patients. Poor hospital outcomes were observed in 30.4% and associated with an admission GCS < 13, hemodynamic instability, intracerebral hemorrhage, and hemiplegia (p < 0.05). Conclusion The hospital poor outcomes are observed when patients present with hemodynamic instability, an admission GCS < 13, intracerebral hemorrhage, and hemiplegia. There is a need for optimizing the initial care of patients with PCCI in armed conflict regions. Keywords: Penetrating craniocerebral injury, Intracerebral hemorrhage, Hemodynamic instability, Hospital outcomes, Glasgow outcome score
ISSN:1471-227X
1471-227X
DOI:10.1186/s12873-021-00504-5