Individuals who sustain severe traumatic brain injury (TBI) are at grave risk of death and disability. These patients have the greatest chances of survival and positive long-term outcomes when they receive immediate treatment in the intensive care unit (ICU), where clinicians have the tools to diagnose, treat, and monitor cases of severe TBI. Unfortunately, patients in many areas of the world have limited or delayed access to ICUs, significantly decreasing their chances of recovering from their injuries.
A recent study examined ICU access among patients with severe TBI who were admitted to the ICU at a large health care center in Ibadan, the third-most populous city in Nigeria. The researchers aimed to determine which patients had the best access to the ICU and how this access influenced their recovery trajectories. After analyzing hospital records, the researchers found that:
- Only 70 percent of severe TBI patients had access to the ICU.
- Critically, all of the patients who were admitted to the ICU experienced significant delays in admission due to lack of space in the ICU. On average, patients waited 13 hours between injury and ICU admission.
- Patients who were successfully admitted to ICU were significantly more likely to survive their injuries than those who could not access ICU treatment.
Although ICUs at large health care centers typically are equipped to treat individuals with severe TBI, limited bed availability may prevent patients from receiving care in time to ensure their survival and recovery. There is a critical need to expand the capacity of trauma ICUs to immediately accommodate patients with severe head trauma.
Balogun JA, Akwada O, Awana E, & Balogun FM. Access to the intensive care unit by severe head injury patients. Journal of Neurosciences in Rural Practice. (October 2019.)