Factors Associated with Adverse Outcomes in Cameroonian Patients with Traumatic Brain Injury: A Cross-Sectional Study

-BACKGROUND: The burden of traumatic brain injury (TBI) disproportionately affects low-and middle-income countries. In Cameroon, the estimated annual incidence rate is 572 cases per 100,000 people. This study investi-gated factors associated with adverse outcomes in the management of Cameroonian patients with TBI.METHODS: This cross-sectional study included all pa-tients with TBI treated between January 1 and December 31, 2018, at 2 Cameroonian referral hospitals. Sociodemo-graphic and clinical data were extracted from patient charts and admission registries and analyzed with SPSS v.26. Independent t tests, odds ratios, and cumulative mortality hazard rates were computed. A P-value <0.05 was considered statistically significant. Also, binomial regres-sion analyses were calculated.RESULTS: One hundred seventy-one patients aged 38.63 + 20.46 years old received treatment for TBI. Most patients were male (78.9%), Cameroonian (98.2%), from ur-ban areas (75.4%), and uninsured (88.8%). The average admission length was 11.23 + 10.71 days, during which 27.5% of patients received surgical treatment while 72.5% received non-surgical (conservative) management. From postdischarge day 12 onwards, surgically-treated patients had a greater cumulative mortality hazard rate than conservatively-treated patients. By 28 days postdischarge, 66.1% of patients had recovered completely [Glasgow Outcome Scale (GOS) = 5], 23.4% had a disability (GOS = 2e4), and 10.5% expired (GOS = 1). Complete re-covery was associated with the absence of severe TBI (B = L1.42, standard error [SE] = 0.52, P = 0.006), disability was associated with increased injury-to-admission delay (B = L1.27, SE = 0.48, P = 0.009), and death was associated with severe TBI (B = 3.16, SE = 0.73, P< 0.001).CONCLUSIONS: We identified factors associated with u nfavorable outcomes among Cameroonian patients with TBI. These results can inform triage and referral practices and aid policymakers in developing context-specific pre-hospital guidelines.