Epidemiology of Traumatic Brain Injuries at a Major Government Hospital in Cambodia

dc.contributor.advisorMihalic, Angelaen
dc.contributor.committeeMemberMadden, Christopheren
dc.contributor.committeeMemberGatson, Joshuaen
dc.creatorPeeters, Sophie Moniqueen
dc.date.submittedJune 2017
dc.descriptionThe general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.en
dc.description.abstractBACKGROUND: Traumatic brain injury (TBI) is a critical public health problem worldwide with a significant socioeconomic burden. While improved safety regulations in high-income countries have resulted in a decline in traffic-related TBI, the incidence of TBI in low-income countries is on the rise. We illustrate the trends and factors involved in TBI in a large Cambodian governmental hospital in Phnom Penh. Additionally, suggestions for improvement of the country's road traffic safety are discussed. METHODS: This is a cross-sectional study of all patients who presented with traumatic brain injury to Department of Neurosurgery at Preah Kossamak Hospital in Phnom Penh, Cambodia between November 2013 and March 2016. RESULTS: Traumatic brain injuries in Cambodia are on the rise. 34% occur during rush hour, 5 to 9pm, and 40% during the weekend. The vast majority (74%) is due to road traffic accidents, of which 81% are motorcycle related. Helmet wear remains low at 13% and recent alcohol use was reported as 38%. The most common diagnosis is skull fracture. The subdural to epidural hematoma ratio was 1:1.05. Lastly, in both subdural and epidural hematomas the frontal lobe was most commonly involved, with 60% of epidural hematomas associated with a lucid interval. CONCLUSIONS: Our study suggests prevention and management of TBIs can have a measurable public health impact in Cambodia. Initiative examples include helmet safety awareness campaigns, stricter penalties, improvement of pre-hospital care, and more efficient triage. High proportion of un-helmeted motorcycle accidents correlates with a rise in epidural hematomas.en
dc.subjectAccidents, Trafficen
dc.subjectAlcohol Drinkingen
dc.subjectBrain Injuries, Traumaticen
dc.subjectHospitals, Publicen
dc.subjectSkull Fracturesen
dc.titleEpidemiology of Traumatic Brain Injuries at a Major Government Hospital in Cambodiaen
thesis.degree.departmentUT Southwestern Medical Schoolen
thesis.degree.disciplineGlobal Healthen
thesis.degree.grantorUT Southwestern Medical Centeren
thesis.degree.nameM.D. with Distinctionen