LAUSR

BACKGROUND Depressed skull fracture (DSF) is one of the most common neurosurgical emergencies in Ethiopia. The clinical outcome after surgical management and what factors predict the outcome are not well-studied. Our study aimed to assess the outcome and identify predictors of the outcome in surgically treated adult patients. METHODOLOGY A prospective, multicenter, observational study was undertaken on 197 cases, at four selected neurosurgical teaching hospitals in Ethiopia. Relevant data were collected and analyzed using SPSS. The outcome was assessed by the extended Glasgow outcome scale. Multivariate analysis was done to identify independent predictors of the outcome. RESULTS The outcome was favorable in 81.2%. The mean age was 27. The mode of injury was violence in 79.7%. Motor deficit witnessed in 24.4%. Based on GCS 92.2% of patients had mild TBI. Associated intracranial lesions were identified in 87.3%. The median days of hospital stay were 4.7 days. Reoperation and mortality rates were 4.1% and 0.5% respectively. Five factors were statistically significant independent predictors of unfavorable outcome in multivariate analysis: motor deficit (adjusted OR 13.8, 95% CI: 4.13-46.17, P=0.000), GCS ≤13 (adjusted OR 10.36, 95% CI: 1.93-55.56, P=0.006), pneumocephalus (adjusted OR 12.93, 95% CI: 3.12-53.52, P=0.000), hospital stay for ≥ 3 days (adjusted OR 4.39, 95% CI: 1.18-16.3, P=0.027), and re-operation (adjusted OR 6.92, 95% CI: 1.09- 43.97, P=0.04). CONCLUSION The overall outcome was favorable. The presence of motor deficit, post-resuscitation GCS ≤ 13, pneumocephalus, re-operation, and hospital stays for ≥ 3 days were independent predictors of an unfavorable outcome.