Mortality Factors of Brain Damaged Patients in the Intensive Care Unit of the University Hospital Center of Anosiala Madagascar

Introduction

The brain damaged patients are the patients with central nervous system injured due to trauma or non-traumatic origins. The main objective of this study is to determine the mortality factors of brain-damaged patients in intensive care and secondarily to analyze the epidemiological and clinical aspects of these patients.

Patients and methods

This is a retrospective, descriptive and analytical study of brain-damaged patients in intensive care unit of the university hospital center of Anosiala Antananarivo over a period of 42 months from January 2019 to June 2022. The primary endpoint was patient mortality within the first thirty days of intensive care stay. The statistical test used was the binary logistic regression model on SPSS 18.0 with a statistically significant test if p<0.05.

Results

At all, 114 patients were included with an average age of 60 +/- 16 years old and a sex ratio of 1.2. Strokes were the main etiologies (81% of cases including 67% hemorrhagic and 33% ischemic). The mortality rate was 63.2%. Statistically significant factors associated with mortality were the age > 55ans (p=0.02), female gender (p=0.01), initial Glasgow Coma Scale <8 (p=0.001), Charlson comorbidity index ≥1 (p=0.005), NIHSS>15 (p=0.008) and hemorrhagic nature of stroke (p= 0.02). The symptoms durations before admission >12 hours (OR=10.62) were not significant.

Conclusion

Predicting the prognosis of brain-damaged patients in intensive care is essential in their management. This study allowed to determine clinical and paraclinical elements associated with their mortality.