Head injuries are a major cause of morbidity and mortality through out the world. It is
estimated that 69 million people suffer from Traumatic Brain Injury (TBI) from all cases
per year .
Current estimates suggest that about 4.48 million people lose their lives due to injuries
which accounts for 8% of all deaths globally. Of these, an estimated 2 million deaths
were attributed to the TBI, and the burden was concentrated in developing countries due
to limited access to advanced life-sustaining measures after trauma .
In low-and middle-income countries, head injury patients have worse outcomes than
patients in high-income countries . Several studies in Africa have found that death rates
from head injury range from 4.2% to 35% .
Evidence suggests that the possible causes for the high mortality rate could be older
age, male gender,low GCS, and cause of injuries are likely non-modifiable risk factors
and hypoxia, hypotension, hyperthermia, hypo or hyperglycemia, and did not undergo
surgery or poor adherence to management guidelines are possible modifiable risk factors .
Clinical presentation of patients and advanced rescue care by emergency teams are crucial
factors to determining favorable outcomes. Accordingly, non-surgical management should
emphases on rapid transportation, avoiding hypotension and hypoxia, hyperthermia, and
medical management to reduce brain edema .
Accurate determination of the prognosis is crucial for the practitioners, in order to
optimize and personalize treatment strategies. There is a degree of uncertainty in
clinicians' expectations of patient outcomes, and prognostic models can help improve
these expectations by providing probabilities of specific outcomes. Compared with the
experience of physicians to judge the prognosis of patients, objective prognostic models
would be able to give more accurate projections about specific variables such as number
of hospitalizations and deaths .
The predictors of mortality modules used are GCS, APACHE II and RTS scores. GCS provides
an objective recording of the state of consciousness of a person, which is the only
variable referring to brain function in the APACHE II score. APACHE II score was
primarily designed to predict mortality in ICUs. The famous models: the International
Mission for Prognosis and Analysis of Clinical Trials (IMPACT) model and the
Corticosteroid Randomization After Significant Head Injury (CRASH) model were weighted
towards mixed TBI (moderate and severe TBI).
The management of TBI patients should be followed intracranial pressure monitoring is
suggested to reduce post-traumatic death in the hospital within two weeks .
Unfortunately, pre hospital care is not well established and hospitals are not well
equipped;this can increase the risk of secondary brain injury due to hypotension and
hypoxia .
