Browsing by Author "Sisay Dedefo"

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    Survival Status and Predictors of Mortality in Adults Undergoing Craniotomy For Traumatic Brain Injury: A Multi-Center Retrospective Cohort Study, Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-07) Sisay Dedefo; Senait Awoke; Wubayehu Amare
    BACKGROUND: Traumatic brain injury (TBI) accounts for a significant number of morbidities and mortalities globally, especially in low resource settings. Craniotomy is performed to reduce intracranial pressure and treat complications. however, survival outcomes and their predictors remain poorly defined, especially in low-resource setting. OBJECTIVE: This Study aimed to assess the Survival status and predictors of mortality on patient age greater than 18 years who underwent Craniotomy for Indication of Traumatic brain injury at Tikur Anbessa Specialized Hospital and ALERT hospital from 2019-2023 GC Ethiopia, Addis Ababa. METHODS: A five years A retrospective cohort study was conducted with 121 TBI patients who underwent craniotomy. Data was gathered through medical record review and analysed using Kaplan–Meier survival analysis (survival analysis) and Cox proportional hazards models (Cox model). The log-rank test was used to compare survival distributions among subgroups of patients. Results: The overall mortality rate was 22% with its 95% CI: 14.6% to 29.4%), with a time of 6 months. The most deaths (19 deaths) occurred during the first observation interval, with a hazard ratio of 0.17 at that interval. Advanced age (AHR = 6.20; 95% CI: 2.37-16.19; p = 0.001); severe TBI (AHR= 6.06; 95% CI: 1.94-18.96; p = 0.002); intra-operative hypotension (AHR= 8.47; 95% CI: 2.81-25.55; p=0.001); and post-operative mechanical ventilation (AHR = 4.71; 95% CI: 1.35-16.36; p = 0.015) were independent predictors of mortality. Conclusion: The study showed a significant mortality burden amongst post-craniotomy TBI patients due to both non-modifiable risk factors (age, severity of injury) and modifiable risk factors (hypotension, ventilation). These findings emphasize the need for prompt surgical management, more precise intra-operative monitoring, and effective postoperative management. Therefore, all stakeholders (policymakers, health care service providers, and researchers) need to work together to improve publicly funded trauma care systems to foster improved survivorship resource.