EVALUATION OF INTENSIVE CARE UNIT (ICU) ADMISSION CRITERIA AND DETERMINANTS OF PATIENT OUTCOMES AFTER TRAUMATIC BRAIN INJURY IN FOUR HOSPITALS IN CAMEROON chichomefire@gmail.com

PW05-15

EVALUATION OF INTENSIVE CARE UNIT (ICU) ADMISSION CRITERIA AND DETERMINANTS OF PATIENT OUTCOMES AFTER TRAUMATIC BRAIN INJURY IN FOUR HOSPITALS IN CAMEROON

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Cameroon

Oral or Poster

Traumatic brain injury (TBI) is a major cause of morbidity and mortality in low- and middle-income countries. In Cameroon, intensive care unit (ICU) admission criteria after TBI remain poorly defined, potentially affecting patient outcomes.

This was a five-year retrospective multicentre cross-sectional study conducted at Buea Regional Hospital, Limbe Regional Hospital, Douala General Hospital, and Douala Gyneco-Obstetric and Paediatric Hospital. Medical records of adult TBI patients admitted to ICUs between January 1st, 2020, and December 31st, 2024, were reviewed for sociodemographic data, clinical presentation, radiologic findings, ICU admission reasons, infrastructure, and patients’ outcome. Data were analysed for factors determining ICU admissions and predictors of outcomes using descriptive statistics and logistic regression models with significance set at p < 0.05.

Out of 399 eligible cases, 53.1% were admitted for GCS <9 and 29.3% for polytrauma. Mortality was highest in patients with GCS <9 (58.1%), hypoxia (72.1%), and hypotension (88.5%). GCS <9 (aOR = 2.00), abnormal pupillary response (aOR = 2.93), hypoxia (aOR = 2.34), hypotension (aOR = 5.74), and increasing age (aOR = 1.02 per year) were significantly associated with mortality. Poor functional outcomes (GOS 1 or 2) were associated with the same factors. Diffuse axonal injury (β = 5.35; p = 0.012) and cerebral edema (β = 4.99; p = 0.012) significantly associated with prolonged ICU stay.

Conclusion: GCS <9, abnormal pupils, hypoxia, hypotension, and age predict ICU mortality and poor recovery. Diffuse axonal injury and cerebral edema significantly extend ICU stay. These findings highlight the need for context-specific ICU triage protocols to optimize resource allocation.