Severe Traumatic Brain Injury: The Contribution of Neurosurgery to Treatment and Economic Costs at the CNHU-HKM in Cotonou

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Introduction: Severe Traumatic Brain Injury (TBI) is a major public health problem in Low- and Middle-Income Countries (LMICs). Objective: The objective of this study is to evaluate the role of neurosurgery in the management of severe TBI in adults and its economic impact in 2022 in a tertiary hospital in Benin. Methods: We conducted a retrospective cohort study (2017-2021) at the CNHU-HKM in Cotonou. Patients aged 15 years and older with a Glasgow Coma Scale score of ≤ 8 were included. Sociodemographic, clinical, paraclinical, therapeutic and economic data were collected from medical records and analysed using Epi Info (chi2 tests, p Results: Sixty-four records were analysed. The mean age was 36.25 ± 13.41 years. The sex ratio was 6.1. Road traffic accidents were involved in 92.2% of cases. Brain computed tomography was performed in 39.1% of cases. Surgery was performed in 18.8% of cases. Mortality was 81.3%. Mortality was associated with a low Glasgow Coma Scale score, mydriasis, absence of pre-hospital care and absence of surgery. The average cost of treatment was estimated at 490,977 XOF (~818 USD). Conclusion: Severe TBI in this population is marked by high mortality and a significant economic burden. Neurosurgery improves outcomes when feasible. The economic burden of managing severe head injuries highlights the need for subsidies and prevention.

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