|dc.identifier.citation||Shisoka, J. M., Omondi, L. A., & Kimani, S. T. (2019). Determinants of the outcome on traumatic brain injury patients at Kenyatta National Hospital. African Journal of Health Sciences, 32(1), 35-47.||en_US
Traumatic brain injury (TBI) is among the leading causes of admissions in hospitals
globally. TBI has been attributed with significant morbidity, mortality and disability. Most
injuries have mainly been attributed to motor accidents and falls from heights.
Traumatic brain injuries represent a significant and growing disease burden in the
developing world, and one of the leading causes of death in economically active adults in many
low- and middle-income countries.
In Kenya, motor vehicle accidents, assaults and motorcycle are significant causes. Per
vehicle mile travelled, motorcycle riders have a 34-fold higher risk of death in a crash than people
driving vehicles and 8 times more likely to be injured. neurological injury progresses over hours and
days, resulting in a secondary injury. Inflammatory and neurotoxic processes result in vasogenic
fluid accumulation within the brain, contributing to raised intracranial pressure, hypoperfusion,
and cerebral ischaemia a secondary injury may be amenable to intervention. Almost one-third of
patients who die after a TBI will talk or obey commands before their death.
Physiological insults, Hypoxia, hypotension, hyper - or hypocapnia, hyper - or hypoglycaemia
have all been shown to increase the risk of secondary brain injury
To determine the patients’ factor, clinical care and systems factor affecting outcome of
Traumatic Brain Injury (TBI) patients at Kenyatta National Hospital. Which led to a poor outcome
of above 40 years, casual laborers, Polytrauma and time lapse from trauma to hospitalization
experienced. The clinical care factors indicating good outcome which included; diagnosis and
medication, Nursing care and clinical setting A&E, CCU. Length of hospitalization >10 days.
Protocols factors; Patients in surgical wards recording poor outcome.
The rationale for using purposive sampling was to be able to distinguish between traumatic
brain injury patients, who did not have any neurological problems before the injury, and those
who had suffered neurological problems prior to trauma. A descriptive cross-sectional design,
Purposive sampling and Quantitative approach to data collection, analysis and presentation was
The study was carried out at the Accident and Emergency department (A&E), Critical
care unit (CCU) and surgical wards of Kenyatta National Hospital (KNH).
Patients with TBI within 72 hours of injury, aged between 18- 65 years and should have
had no previous neurological problem.
Patient factors; that led to poor outcome; above 40 years (p=0.042), casual laborers (p=0.043),
Polytrauma (p=0.042) and time lapse from trauma to hospitalization (p=0.051). The clinical care
factors indicated good outcome which included; diagnosis and medication (p=0.001), Nursing care
(p=0.055) and clinical setting A&E (p=0.051), CCU (p=0.032). Length of hospitalization >10 days
(p=0.050). Protocols factors; Patients in surgical wards had poor outcome (p=0.051).
Patient factor's influenced outcome of TBI, Intensive care and longer time of hospitalization
is paramount for better outcome.
Setup of a Trauma Neuro Ward and training of Neuro Teams to facilitate professional and
quality care to improve outcome of Traumatic Brain Injury patients.||en_US