Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct;8(4):30-8.

Traumatic Brain Injury Related to Motor Vehicle Accidents in Guinea: Impact of Treatment Delay, Access to Healthcare, and Patient's Financial Capacity on Length of Hospital Stay and In-hospital Mortality

Kézély Béavogui  1 , Akoï Koïvogui  2 , Tokpagnan Oscar Loua  1 , Ramata Baldé  3 , Boubacar Diallo  3 , Aminata Rougui Diallo  3 , Zézé Béavogui  3 , Koué Goumou  3 , Vamala Guilavogui  2 , N'famara Sylla  4 , Morad Chughtai  5 , Adnan I Qureshi  6 , Aissatou Taran Diallo  3 , Naby Daouda Camara  3
Affiliations

Traumatic Brain Injury Related to Motor Vehicle Accidents in Guinea: Impact of Treatment Delay, Access to Healthcare, and Patient's Financial Capacity on Length of Hospital Stay and In-hospital Mortality

Kézély Béavogui et al. J Vasc Interv Neurol. 2015 Oct.

Abstract

Background: Traumatic brain injury related to road traffic accidents poses a major challenge in resource-poor settings within Guinea.

Objective: To analyze the impact of treatment delay, access to healthcare, and patient's financial capacity on duration of hospital stay and in-hospital mortality.

Methodology: Data from patients with traumatic brain injury secondary to motor vehicle accident admitted to a reference hospital (public or private) in Guinea during 2009 were analyzed. The association between various factors (treatment delay, access to healthcare, and patient's financial capacity) and prolonged hospital stay (>21 days) and in-hospital mortality were analyzed using two multivariate logistic regression models.

Results: The mean (±standard deviation) duration of hospital stay was 8.0 (±8.1) days. The risk of prolonged hospital stay increased by 60% when the time interval between accident and hospital arrival was greater than 12 hours compared with those in whom the time interval was less than 6 hours (adjusted odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.0-2.6, p = 0.03). Compared with patients with low-financial capacity, patients with medium-financial capacity (adjusted OR = 0.6, 95% CI = 0.4-0.8, p = 0.001) and those with high capacity (adjusted OR = 0.6, 95% CI = 0.4-0.9, p = 0.02) were less likely to have a prolonged hospital stay. The risk of in-hospital mortality was 2.6 times higher in patients with time interval between accident and hospital arrival greater than 12 hours compared with those in whom the time interval was less than 6 hours (adjusted OR = 2.6, 95% CI = 1.1-6.2 p = 0.03). In-hospital mortality was not related to patient's financial capacity.

Conclusion: Prolonged hospital stay and higher in-hospital mortality was associated with longer time interval between accident and hospital arrival. This delay is attributed to inadequate condition of intercity roads and lack of emergency medical services.

Keywords: Ability to finance care; delay to access to healthcare; hospital mortality; length of hospital stay; traumatic brain injury.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Length of hospital stay according to financial capability and strata based on time interval between TBI and hospital arrival.
Figure 2
Figure 2. Distribution of in-hospital mortality, population, and mean length of hospital stay in days by administrative regions within Guinea.
See this image and copyright information in PMC

References

    1. Bruder N. [Transfer of emergency neurosurgical patients: when and how?] Ann Fr Anesth Reanim. 2007;26(10):873–877. - PubMed
    1. Rickels E, von Wild K, Wenzlaff P. Head injury in Germany: a population-based prospective study on epidemiology, causes, treatment and outcome of all degrees of head-injury severity in two distinct areas. Brain Inj. 2010;24(12):1491–1504. - PubMed
    1. Bahloul M, Chelly H, Chaari A, Imen C, Sondes H, Leila H, Hassen D, Chokri H, Hichem K, Hatem K, Noureddine R, Mounir B. Isolated traumatic head injury in children: Analysis of 276 observations. J Emerg Trauma Shock. 2011;4(1):29–36. - PMC - PubMed
    1. Mathe JF, Richard I, Rome J. [Serious brain injury and public health, epidemiologic and financial considerations, comprehensive management and care] Ann Fr Anesth Reanim. 2005;24(6):688–694. - PubMed
    1. Rosso A, Brazinova A, Janciak I, Wilbacher I, Rusnak M, Mauritz W. Severe traumatic brain injury in Austria II: epidemiology of hospital admissions. Wien Klin Wochenschr. 2007;119(1–2):29–34. - PubMed

LinkOut - more resources