• Mabrouk Bahloul, Hedi Chelly, Mohamed Ben Hmida, Chokri Ben Hamida, Hichem Ksibi, Hatem Kallel, Adel Chaari, Mondher Kassis, Noureddine Rekik, and Mounir Bouaziz.
• Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia. bahloulmab@yahoo.fr
• J Trauma. 2004 Aug 1;57(2):255-61.

BackgroundThis study aimed to determine predictive factors of mortality after posttraumatic brain injury.MethodsA retrospective study conducted over a 3-year period (1997-1999) involved 437 adult patients with head injury admitted to the intensive care unit of a university hospital in Sfax, Tunisia. Basic demographic, clinical, biologic, and radiologic data were recorded at admission and during the intensive care unit stay.ResultsThis study included 393 men (90%) and 44 women with a mean age of 36 +/- 17 years. Traffic accidents were the main cause of trauma (85.6%). In 58% of the cases, the injury was serious (Glasgow Coma Score, <8). The mean simplified acute physiology score was 39 +/- 15, and the mean Injury Severity Score was 34.5 +/- 17. Of the 437 patients, 127 (29.1%) died. According to multivariate analysis, the factors that correlated with a poor prognosis were age older than 40 years (p < 0.01), simplified acute physiology score exceeding 40 (p < 0.001), Glasgow Coma Score lower than 7 (p = 0.03), intracranial mass lesion (p = 0.02), a cerebral herniation (p < 0.001), diabetes insipidus (p < 0.001), and blood sugar level higher than 10 mmol/L (p < 0. 001).ConclusionsIn Tunisia, head injury is a frequent cause of hospitalization, comprising 14.4% of all adult admissions. It is observed most often among young patients involved in traffic accidents. The short-term prognosis is poor, with a high (29%) mortality rate, and determined by demographic, clinical, radiologic, and biologic factors. Prevention is highly advised.

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