PROGNOSTIC IMPACT OF PREHOSPITAL MANAGEMENT IN TRAUMATIC BRAIN INJURY

• Dr.Rania AMMAR ZAYANI

  university of sfax faculty of medecine of sfax

• Dr. Jihen Bach Hamba

  Faculty of Medicine of Sfax

• Dr. Marwa Ben Abdallah

  Faculty of Medicine of Sfax

• Dr. Nedia Bjaoui

  Faculty of Medicine of Sfax

• Dr. Mabrouk Bahloul

  Faculty of Medicine of Sfax

• Dr. Adel Chaari

  Faculty of Medicine of Sfax

• Dr.Chokri Ben Hamida

Background: Traumatic brain injury (TBI) remains a major global health concern, with prehospital management playing a decisive role in both survival and neurological recovery. The actions performed at the accident scene can prevent or exacerbate secondary brain injury, particularly through their impact on oxygenation, perfusion, and immobilization quality. Objective:To evaluate the prognostic and functional impact of prehospital management among patients with TBI admitted to the intensive care unit (ICU). Methods: A retrospective, descriptive, and analytical study was conducted over six months (January–June 2025) in the medical ICU of Habib Bourguiba University Hospital, Sfax (Tunisia). We included all patients over 16 years old admitted for TBI with documented prehospital care. Functional outcomes were categorized using the Glasgow Outcome Scale (GOS) as poor (GOS 2–3) or good (GOS 4–5). Data were analyzed using SPSS v25.0. Results: Twenty-seven patients were included (median age 33 years; 74.1% male). Road traffic accidents accounted for 96.3% of cases. Median prehospital Glasgow Coma Scale (GCS) was 10. Prehospital care was provided mainly by the Mobile Emergency and Resuscitation Service (MERS) (59.5%). Interventions included oxygen therapy (25.9%), intubation (25.9%), and cervical immobilization (100%). The median delay between trauma and hospital arrival was 30 minutes. Mortality reached 18.5%. Pupillary abnormalities at both prehospital and admission stages were significantly associated with mortality (p = 0.02). Longer ICU and hospital stays were significantly associated with poor functional outcomes (p = 0.034 and p = 0.04, respectively). Conclusion: The prognosis of TBI patients depends not only on injury severity but also on the quality and timeliness of prehospital management. Rapid medicalized intervention, continuous monitoring, and safe transport significantly reduce mortality and functional disability.

1. Dr.Rania AMMAR ZAYANI, university of sfax faculty of medecine of sfax

   1. Department of Medical Intensive Care, Habib Bourguiba University Hospital, university of Sfax,  Tunisia

2. Dr. Jihen Bach Hamba, Faculty of Medicine of Sfax

   1. Department of Medical Intensive Care, Habib Bourguiba University Hospital, university of Sfax,  Tunisia

3. Dr. Marwa Ben Abdallah, Faculty of Medicine of Sfax

   2. Emergency Medical Assistance Service (EMAS 04),university of Sfax,  Tunisia

4. Dr. Nedia Bjaoui, Faculty of Medicine of Sfax

   2. Emergency Medical Assistance Service (EMAS 04),university of Sfax,  Tunisia

5. Dr. Mabrouk Bahloul, Faculty of Medicine of Sfax

   1. Department of Medical Intensive Care, Habib Bourguiba University Hospital, university of Sfax,  Tunisia

6. Dr. Adel Chaari, Faculty of Medicine of Sfax

   2. Emergency Medical Assistance Service (EMAS 04),university of Sfax,  Tunisia

7. Dr.Chokri Ben Hamida

    

   1. Department of Medical Intensive Care, Habib Bourguiba University Hospital, university of Sfax,  Tunisia

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