Objective: This study aims to evaluate the influence of social and cultural factors on the aetiology and outcome of traumatic brain injury (TBI) in two modern units serving geographically and socioculturally different communities, Doha Neurosurgical Centre (Qatar, Arabian Gulf) and the Regional Neurosciences Centre in Newcastle upon Tyne (UK).
Method: All TBI patients admitted to either centre over a contemporary 5-year period were reviewed. Demographic details, date of admission, mechanism of injury, neurological status on admission and associated extracranial injuries were noted. The end-point was Glasgow Outcome at discharge. Proportions were compared using the chi-square test. A multiple logistic regression technique was used to identify significant determinants of outcome.
Results: There was a significant male preponderance in Doha (93%) compared with Newcastle (73%, p50.001). More patients presented in coma in Doha (42%) than in Newcastle (18%, p50.001). Road traffic accident (RTA) was the commonest cause of TBI in Doha (68%) and accounted for 80% of fatalities. In Newcastle, RTA was responsible for only 20% of TBI. The mortality for comatose patients in Doha (45%) was twice that in Newcastle (23.5%). Overall favourable outcome was significantly higher in Newcastle (81%) compared with Doha (74%, p50.003). Multiple logistic regression identified Glasgow coma score and age as the most important determinants of outcome.
Conclusion: This study confirms that despite similarities in the organization of care, mortality from severe TBI is significantly higher in Qatar due most probably to the higher incidence of RTAs. We therefore recommend that any scheme aiming to reduce mortality following TBI should include intensive preventive road safety measures.
Mendelow AD, Igbaseimokumo U, Bashir EF, Stobbart L, Chambers IR, Gregson BA, Taha Z. Comparative study of traumatic brain injury between Great Britain and Qatar. British Journal of Neurosurgery, October 2003; 17(5): 481.
Dr. Iain R. Chambers, Cleveland Unit, Middlesbrough. Tel: +44 (0)1642-854-778.
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
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