• Linda W Xu, Silvia D Vaca, Juliet Nalwanga, Christine Muhumuza, Daniel Vail, Benjamin J Lerman, Joel Kiryabwire, Hussein Ssenyonjo, John Mukasa, Michael Muhumuza, Michael M Haglund, and Gerald Grant.
• Department of Neurosurgery, Stanford University, Palo Alto, California, USA; Stanford Center for Global Health Innovation, Palo Alto, California, USA. Electronic address: lindawxu@stanford.edu.
• World Neurosurg. 2018 May 1; 113: e153-e160.

BackgroundIn the past decade, neurosurgery in Uganda experienced increasing surgical volume and a new residency training program. Although research has examined surgical capacity, minimal data exist on the patient population treated by neurosurgery and their eventual outcomes in sub-Saharan Africa.MethodsPatients admitted to Mulago National Referral Hospital neurosurgical ward over 2 years (2014 and 2015) were documented in a prospective database. In total, 1167 were discharged with documented phone numbers and thus eligible for follow-up. Phone surveys were developed and conducted in the participant's language to assess mortality, neurologic outcomes, and follow-up health care.ResultsDuring the study period, 2032 patients were admitted to the neurosurgical ward, 80% for traumatic brain injury. A total of 7.8% received surgical intervention. The in-hospital mortality rate was 18%. A total of 870 patients were reached for phone follow-up, a 75% response rate, and 30-day and 1-year mortality were 4% and 8%, respectively. Almost one-half of patients had not had subsequent health care after the initial encounter. Most patients had Glasgow Outcome Scale-Extended scores consistent with good recovery and mild disability, with patients experiencing trauma faring best and patients with tumor faring worst. A total of 85% felt they returned to baseline work performance, and 76% of guardians felt that children returned to baseline school performance.ConclusionsThe neurosurgical service provided health care to a large proportion of nonoperative patients. Phone surveys captured data on patients in whom nearly one-half would be lost to subsequent health care. Although mortality during initial hospitalization was high, more than 90% of those discharged survived at 1-year follow up, and the vast majority returned to work and school.Copyright © 2018 Elsevier Inc. All rights reserved.

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