• Stéphane Nguembu, Yves Jordan Kenfack, Samantha Sadler, Yvan Zolo, Bello Figuim, Lorraine Arabang Sebopelo, Francklin Tétinou, and Ulrick Sidney Kanmounye.
• Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.
• World Neurosurg. 2023 Apr 1; 172: e62e67e62-e67.

BackgroundThe 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 investigated factors associated with adverse outcomes in the management of Cameroonian patients with TBI.MethodsThis cross-sectional study included all patients with TBI treated between January 1 and December 31, 2018, at 2 Cameroonian referral hospitals. Sociodemographic 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 regression analyses were calculated.ResultsOne 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 urban 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 = 2-4), and 10.5% expired (GOS = 1). Complete recovery was associated with the absence of severe TBI (B = -1.42, standard error [SE] = 0.52, P = 0.006), disability was associated with increased injury-to-admission delay (B = -1.27, SE = 0.48, P = 0.009), and death was associated with severe TBI (B = 3.16, SE = 0.73, P < 0.001).ConclusionsWe identified factors associated with unfavorable outcomes among Cameroonian patients with TBI. These results can inform triage and referral practices and aid policymakers in developing context-specific prehospital guidelines.Copyright © 2022 Elsevier Inc. All rights reserved.

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