Prevalence of severe neurobehavioral disorders among adults with traumatic brain injury at Mbarara Regional Referral Hospital in southwestern Uganda

Abstract

BACKGROUND: Traumatic brain injuries (TBI) are frequently accompanied by neuropsychiatric disturbances. Failure to quickly assess and manage these disturbances results in neurobehavioral syndromes, with deleterious effects on recovery and rehabilitation outcomes. This study determined the prevalence and predictors of severe neurobehavioral disorders among patients with TBI at Mbarara Regional Referral Hospital in southwestern Uganda. METHODS: In this cross-sectional study, we enrolled participants aged 18 years or older who were able to communicate meaningfully and had been discharged by the neurosurgical team. We obtained information on socio-demographic characteristics, alcohol use, length of stay in the hospital, Glasgow Coma Scale (GCS) score at admission, clinical diagnosis, treatments given, and investigations, including brain computed tomography scans. Neurobehavioral disorders were determined using the Neurobehavioral Rating Scale. Predictors of neurobehavioral disorders were determined using logistic regression. RESULTS: Of the 196 participants, 139 (70.8%) were male. The Median age (interquartile range (IQR)) was 30 (23-40) years, and the median length of hospital stay (IQR) was 7 (5-10) days; median GCS (IQR) was 13/15 (10/15 - 14/15), and the prevalence of neurobehavioral disorders was 55.4%. Factors associated with neurobehavioral disorders were age > 35 years (odds ratio (O.R) = 4.7 (1.6-13.5) and > 7 days of hospital admission (O.R = 4.3 (1.4-13.0). Having a GCS score of 13-15 at admission was protective (O.R = 0.13 (0.02-0.85) against neurobehavioral disorders compared to a score of < 8. CONCLUSION: The high prevalence of neurobehavioral disorders among individuals with a history of TBI at the point of discharge from the hospital may affect post-discharge care. Hence, there is a need to meticulously assess and address these challenges early to improve the long-term treatment outcomes of TBI. CLINICAL TRIAL NUMBER: Not applicable.