Pattern and outcome of traumatic brain injury among patients admitted in neurosurgery ICU.

Abstract

Objective: To evaluate the pattern and outcomes of traumatic brain injury among patients admitted to the neurosurgery ICU. Study Design: Cross Sectional Analytical study. Setting: Neurosurgery ICU of Allama Iqbal Teaching Hospital. Period: January to December 2024. Methods: Total 323 patients with confirmed TBI were enrolled using non-probability consecutive sampling. Data on demographics, injury mechanism, clinical presentation, radiological findings, management, complications and outcomes were collected. Outcomes included in-hospital mortality and functional status assessed via the Glasgow Outcome Scale (GOS). Multivariable logistic regression was used to identify predictors of mortality. Data were analyzed using SPSS version 23.0. Results: The mean age was 38.6 ± 16.4 years with 78.0% male predominance. Road traffic accidents (61.3%) were the leading cause. Severe TBI (GCS ≤8) was present in 44.0% of patients. Subdural hematoma (41.8%) was the most common radiological finding. Surgical intervention was performed in 54.5% of cases. Overall in-hospital mortality rate was 28.8%. Poor functional outcome (GOS 1–3) was observed in 49.8% of patients. Independent predictors of mortality included severe TBI (aOR 12.4, p<0.001), bilateral non-reactive pupils (aOR 8.9, p<0.001) and midline shift ≥5 mm on CT (aOR 3.2, p<0.001). Conclusion: TBI predominantly affects young males with high mortality and poor functional outcomes. Early clinical and radiological indicators are strong predictors of death highlighting need for timely interventions and strengthened neurocritical care infrastructure.