The prevalence of hypotension and hypoxaemia in blunt traumatic brain injury in the prehospital setting of Johannesburg, South Africa: A retrospective chart review

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dc.contributor.authorStassen, W
dc.contributor.authorWelzel, T
dc.date.accessioned2021-10-08T07:20:30Z
dc.date.available2021-10-08T07:20:30Z
dc.date.issued2014
dc.description.abstractBACKGROUND: Each year, ~89 000 (180/100 000) new cases of head injury are reported in South Africa (SA), with the majority of patients being in the economically active population. Hypotension and hypoxaemia significantly increase the morbidity and mortality in patients who have suffered a traumatic brain injury (TBI). Cerebral tissue is particularly vulnerable to these secondary insults in the period immediately following a TBI, emphasising the importance of prehospital care in TBI. OBJECTIVE: To establish the prevalence of prehospital hypotension and hypoxaemia in moderate to severe blunt TBI in greater Johannesburg, Gauteng, SA. METHODS: The records of adult patients who sustained a moderate to severe TBI between 1 January and 31 December 2011 were retrospectively reviewed for hypotension (systolic blood pressure <90 mmHg) and hypoxaemia (oxygen saturation <90%) during their prehospital phase of care. These results were subject to descriptive analysis. RESULTS: A total of 299 records were identified, 66 of which met the inclusion criteria. The prevalence of prehospital hypotension and hypoxaemia were 33.3% (n=22) and 37.9% (n=25), respectively, while 21.2% (n=14) of patients suffered double insults of hypotension and hypoxaemia. Hypotension and hypoxaemia were associated with haemorrhage (p=0.011) and chest injuries (p=0.001), respectively. CONCLUSION: The prevalence of hypotension in this study was similar to that observed in international studies, but the prevalence of hypoxaemia was much higher. There is a need for local guidelines to be developed to inform the quality of TBI care in the context of the developing world.
dc.identifier.apacitationStassen, W., & Welzel, T. (2014). The prevalence of hypotension and hypoxaemia in blunt traumatic brain injury in the prehospital setting of Johannesburg, South Africa: A retrospective chart review. <i>South African Medical Journal</i>, 104(6), 424 - 177. http://hdl.handle.net/11427/34938en_ZA
dc.identifier.chicagocitationStassen, W, and T Welzel "The prevalence of hypotension and hypoxaemia in blunt traumatic brain injury in the prehospital setting of Johannesburg, South Africa: A retrospective chart review." <i>South African Medical Journal</i> 104, 6. (2014): 424 - 177. http://hdl.handle.net/11427/34938en_ZA
dc.identifier.citationStassen, W. & Welzel, T. 2014. The prevalence of hypotension and hypoxaemia in blunt traumatic brain injury in the prehospital setting of Johannesburg, South Africa: A retrospective chart review. <i>South African Medical Journal.</i> 104(6):424 - 177. http://hdl.handle.net/11427/34938en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Stassen, W AU - Welzel, T AB - BACKGROUND: Each year, ~89 000 (180/100 000) new cases of head injury are reported in South Africa (SA), with the majority of patients being in the economically active population. Hypotension and hypoxaemia significantly increase the morbidity and mortality in patients who have suffered a traumatic brain injury (TBI). Cerebral tissue is particularly vulnerable to these secondary insults in the period immediately following a TBI, emphasising the importance of prehospital care in TBI. OBJECTIVE: To establish the prevalence of prehospital hypotension and hypoxaemia in moderate to severe blunt TBI in greater Johannesburg, Gauteng, SA. METHODS: The records of adult patients who sustained a moderate to severe TBI between 1 January and 31 December 2011 were retrospectively reviewed for hypotension (systolic blood pressure <90 mmHg) and hypoxaemia (oxygen saturation <90%) during their prehospital phase of care. These results were subject to descriptive analysis. RESULTS: A total of 299 records were identified, 66 of which met the inclusion criteria. The prevalence of prehospital hypotension and hypoxaemia were 33.3% (n=22) and 37.9% (n=25), respectively, while 21.2% (n=14) of patients suffered double insults of hypotension and hypoxaemia. Hypotension and hypoxaemia were associated with haemorrhage (p=0.011) and chest injuries (p=0.001), respectively. CONCLUSION: The prevalence of hypotension in this study was similar to that observed in international studies, but the prevalence of hypoxaemia was much higher. There is a need for local guidelines to be developed to inform the quality of TBI care in the context of the developing world. DA - 2014 DB - OpenUCT DP - University of Cape Town IS - 6 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2014 SM - 0038-2469 T1 - The prevalence of hypotension and hypoxaemia in blunt traumatic brain injury in the prehospital setting of Johannesburg, South Africa: A retrospective chart review TI - The prevalence of hypotension and hypoxaemia in blunt traumatic brain injury in the prehospital setting of Johannesburg, South Africa: A retrospective chart review UR - http://hdl.handle.net/11427/34938 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34938
dc.identifier.vancouvercitationStassen W, Welzel T. The prevalence of hypotension and hypoxaemia in blunt traumatic brain injury in the prehospital setting of Johannesburg, South Africa: A retrospective chart review. South African Medical Journal. 2014;104(6):424 - 177. http://hdl.handle.net/11427/34938.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Emergency Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue6
dc.source.journalvolume104
dc.source.pagination424 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.7494
dc.subject.otherAdult
dc.subject.otherBrain Injuries
dc.subject.otherCross-Sectional Studies
dc.subject.otherEmergency Medical Services
dc.subject.otherFemale
dc.subject.otherHumans
dc.subject.otherHypotension
dc.subject.otherHypoxia
dc.subject.otherMale
dc.subject.otherMiddle Aged
dc.subject.otherRetrospective Studies
dc.subject.otherSouth Africa
dc.subject.otherUrban Population
dc.titleThe prevalence of hypotension and hypoxaemia in blunt traumatic brain injury in the prehospital setting of Johannesburg, South Africa: A retrospective chart review
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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