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

Authors

  • N Parker Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa
  • T Navsaria Trauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
  • M Lopez Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa
  • L Marineau Johns Hopkins University School of Nursing, Baltimore, USA
  • R Maine Division of Trauma, Burn and Critical Care Surgery, University of Washington, Seattle, USA
  • K Chu Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa
  • T Govender Trauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
  • D McPherson Trauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
  • P Navsaria Trauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

DOI:

https://doi.org/10.7196/SAMJ.2024.v114i17.1829

Keywords:

traumatic brain injury, computed tomgraphy

Abstract

Background. Traumatic 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.

Objective. To describe the referral patterns and outcomes of patients with TBI referred to Groote Schuur Hospital Trauma Centre. Methods. This 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.

Results. A 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.

Conclusion. More 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.

 

 

Author Biographies

  • N Parker, Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa

    Medical Student (V-year)

  • T Navsaria, Trauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

    Researcher

  • M Lopez, Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa

    Medical Student

  • L Marineau, Johns Hopkins University School of Nursing, Baltimore, USA

    PhD Candidate

  • R Maine, Division of Trauma, Burn and Critical Care Surgery, University of Washington, Seattle, USA

    Trauma Surgeon

  • T Govender, Trauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

    General Surgeon

  • D McPherson, Trauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

    Trauma Surgeon

  • P Navsaria, Trauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

    Deputy-head: Trauma Center
    GSH/UCT
    Surgery
    Anzio Road
    Cape Town,
    SOUTH AFRICA

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Published

2024-07-01

Issue

Section

Research

How to Cite

1.
Parker N, Navsaria T, Lopez M, Marineau L, Maine R, Chu K, et al. An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre. S Afr Med J [Internet]. 2024 Jul. 1 [cited 2024 Jul. 18];114(7):e1829. Available from: https://samajournals.co.za/index.php/samj/article/view/1829

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