Traumatic brain injury patient characteristics and outcomes in Lebanon: A multicenter retrospective cohort study

Background This study aims to assess the prevalence of traumatic brain injuries (TBI) and understand the underlying risk factors for their occurrence in Lebanon through examining TBI patient demographics, TBI types, mechanisms and clinical outcomes. It further discusses the treatment and management of the TBI burden in Lebanon, in the economic and political context. Methods We conducted a multicenter, retrospective chart review of TBI patients of all ages who presented with TBI-related complaints to the emergency departments (EDs) at six medical centres in Lebanon from January 2012 to December 2014. Patients’ charts were screened, and data were abstracted into a collection sheet, including patient’s demographics, injury-related information, ED clinical management, and hospital course and discharge information. Results 1042 charts were reviewed; 67.2% of cases were men. The leading causes of TBI were falls (44.3%), followed by road traffic injuries (37.8%), violence (10%), and bombs and cluster munition injuries (4%). Most TBI patients had a Glasgow coma scale (GCS) ranging from 13 to 15 (84.1%). TBI management at ED consisted of neurosurgical consultation and procedures to decrease intracranial pressure. Short-term adverse outcomes included CSF leak in 15 patients (6.1%), papilloedema in 3 (1.3%), and haemotympanum in 13 (5.4%). Conclusions Evidence generated from this study serves as a leading point to bridge research and enhance the policy-making process, despite the prevailing economic and political restrictions. It further advocates setting guidelines to improve TBI prevention, diagnosis, management, and rehabilitative treatment in Lebanon and the entire Middle East and North Africa (MENA) region.