{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:53:05Z","timestamp":1789123985041,"version":"build-2803163510"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"vor","delay-in-days":385,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T00:00:00Z","timestamp":1576713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T00:00:00Z","timestamp":1576713600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,3,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traumatic brain injury (TBI) is a major cause of long-term disability and economic loss to society. The aim of this study was to assess the factors affecting mortality after TBI in a resource-poor setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Chart review was performed for randomly selected patients who presented with TBI between 2013 and 2017 at St Mary's Hospital, Lacor, northern Uganda. Data collected included demographic details, time from injury to presentation, and vital signs on arrival. In-hospital management and mortality were recorded. Severe head injury was defined as a Glasgow Coma Scale score below 9.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 194 patient charts were reviewed. Median age at time of injury was 27 (i.q.r. 2\u201368)\u00a0years. The majority of patients were male (M\u00a0:\u00a0F ratio 4\u00b79\u00a0:\u00a01). Some 30\u00b79 per cent of patients had severe head injury, and an associated skull fracture was observed in 8\u00b78 per cent. Treatment was mainly conservative in 94\u00b78 per cent of patients; three patients (1\u00b75 per cent) had burr-holes, four (2\u00b71 per cent) had a craniotomy, and three (1\u00b75 per cent) had skull fracture elevation. The mortality rate was 33\u00b70 per cent; 46 (72 per cent) of the 64 patients who died had severe head injury. Of the ten surgically treated patients, seven died, including all three patients who had a burr-hole. In multivariable analysis, factors associated with mortality were mean arterial pressure (P\u00a0=\u00a00\u00b7012), referral status (P\u00a0=\u00a00\u00b7001), respiratory distress (P\u00a0=\u00a00\u00b7040), severe head injury (P\u00a0=\u00a00\u00b7011) and pupil reactivity (P\u00a0=\u00a00\u00b7011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TBI in a resource-poor setting remains a major challenge and affects mainly young males. Decisions concerning surgical intervention are compromised by the lack of both CT and intracranial pressure monitoring, with consequent poor outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs5.50243","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:09:38Z","timestamp":1576800578000},"page":"320-325","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Factors affecting mortality after traumatic brain injury in a resource-poor setting"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0573-3866","authenticated-orcid":false,"given":"R","family":"Okidi","sequence":"first","affiliation":[{"name":"Department of Surgery, St Mary's Hospital , Lacor, Uganda"},{"name":"Faculty of Medicine, Gulu University , Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D M","family":"Ogwang","sequence":"additional","affiliation":[{"name":"Department of Surgery, St Mary's Hospital , Lacor, Uganda"},{"name":"Faculty of Medicine, Gulu University , Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T R","family":"Okello","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Lira University , Lira, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Ezati","sequence":"additional","affiliation":[{"name":"Department of Surgery, St Mary's Hospital , Lacor, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Kyegombe","sequence":"additional","affiliation":[{"name":"Department of Surgery, St Mary's Hospital , Lacor, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Nyeko","sequence":"additional","affiliation":[{"name":"Department of Surgery, St Mary's Hospital , Lacor, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9177-1043","authenticated-orcid":false,"given":"N J","family":"Scolding","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Gulu University , Gulu, Uganda"},{"name":"Institute of Clinical Neurosciences, University of Bristol , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,12,19]]},"reference":[{"key":"2023020205203255700_bjs550243-bib-0001","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1080\/02699050410001671919","article-title":"Interpreting the meaning individuals ascribe to returning to work after traumatic brain injury: a qualitative approach","volume":"18","author":"Oppermann","year":"2004","journal-title":"Brain Inj"},{"key":"2023020205203255700_bjs550243-bib-0002","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/00001199-200609000-00001","article-title":"The epidemiology and impact of traumatic brain injury: a brief overview","volume":"21","author":"Langlois","year":"2006","journal-title":"J Head Trauma Rehabil"},{"key":"2023020205203255700_bjs550243-bib-0003","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/01.yco.0000165601.29047.ae","article-title":"Outcome from mild traumatic brain injury","volume":"18","author":"Iverson","year":"2005","journal-title":"Curr Opin Psychiatry"},{"key":"2023020205203255700_bjs550243-bib-0004","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/S1474-4422(17)30362-9","article-title":"Traumatic brain injury: a global challenge","volume":"16","author":"Johnson","year":"2017","journal-title":"Lancet Neurol"},{"key":"2023020205203255700_bjs550243-bib-0005","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0140-6736(74)91639-0","article-title":"Assessment of coma and impaired consciousness. 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