An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre
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 pati...
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| Language: | English |
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South African Medical Association
2024-07-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1829 |
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| author | N Parker T Navsaria M Lopez L Marineau R Maine K Chu T Govender D McPherson P Navsaria |
| author_facet | N Parker T Navsaria M Lopez L Marineau R Maine K Chu T Govender D McPherson P Navsaria |
| author_sort | N Parker |
| collection | DOAJ |
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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.
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| format | Article |
| id | doaj-art-f1662b7e6014428fa15c25322891ba29 |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-f1662b7e6014428fa15c25322891ba292025-02-10T12:25:51ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-07-01114710.7196/SAMJ.2024.v114i17.1829An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma CentreN Parker0T Navsaria1M Lopez2L Marineau3R Maine4K Chu5T Govender6D McPherson7P Navsaria8Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South AfricaTrauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South AfricaCentre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South AfricaJohns Hopkins University School of Nursing, Baltimore, USADivision of Trauma, Burn and Critical Care Surgery, University of Washington, Seattle, USACentre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South AfricaTrauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South AfricaTrauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South AfricaTrauma Centre, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa 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. https://samajournals.co.za/index.php/samj/article/view/1829traumatic brain injury, computed tomgraphy |
| spellingShingle | N Parker T Navsaria M Lopez L Marineau R Maine K Chu T Govender D McPherson P Navsaria An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre South African Medical Journal traumatic brain injury, computed tomgraphy |
| title | An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre |
| title_full | An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre |
| title_fullStr | An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre |
| title_full_unstemmed | An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre |
| title_short | An analysis of referral patterns of traumatic brain injury at Groote Schuur Hospital Trauma Centre |
| title_sort | analysis of referral patterns of traumatic brain injury at groote schuur hospital trauma centre |
| topic | traumatic brain injury, computed tomgraphy |
| url | https://samajournals.co.za/index.php/samj/article/view/1829 |
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