An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre

• Published in: South African medical journal 2024-07, Vol.114 (7), p.24-26
• Main Authors: Parker, N, Navsaria, T, Lopez, M, Marineau, L, Maine, R, Chu, K, Govender, T, McPherson, D, Navsaria, P
• Format: Article
• Language: English
• Subjects: Brain; Computed tomography; CT imaging; Hospitals; Injuries; Medical care, Cost of; Medical imaging equipment; Medical referral; Mortality; South Africa; Statistics; Trauma centers; Traumatic brain injury
• ISSN: 0256-9574; 2078-5135
• DOI: 10.7196/SAMJ.2024.v114i7.1829

\r\nBackground\r\nTraumatic brain injury (TBI) can result in significant morbidity and mortality if not diagnosed in a timely manner. Brain computed tomography (CT) is the diagnostic gold standard but is of limited availability in most South African public hospitals, resulting in transfer of TBI patients to tertiary hospitals.\r\n\r\nObjective\r\nTo describe the referral patterns and outcomes of patients with TBI referred to Groote Schuur Hospital Trauma Centre.\r\n\r\nMethods\r\nThis was a retrospective audit of all patients admitted to the Trauma Centre who had a brain CT scan for suspected TBI between 1 February 2022 and 31 March 2022. Demographic data (age, sex), mechanism of injury and Glasgow Coma Score were recorded. Referral pathways were determined, and final disposition of patients was recorded.\r\n\r\nResults\r\nA total of 522 patients had a brain CT for TBI. Of these, 314 (60.1%) were referred from other hospitals. CT scan was abnormal in 178 (34.1%) patients. Three hundred and two (58.6%) were discharged home within 24 hours. The mean time between referral and CT scan was 13 hours.\r\n\r\nConclusion\r\nMore than half of patients referred for a CT scan were discharged from the Trauma Centre within 24 hours of admission, which indicates additional costs and inefficiencies in the health system. These data are useful to guide resource planning and allocation for district hospitals, since less expensive point-of-care modalities now exist to diagnose TBI, and which are useful in indicating the prognosis of patients.