Functional Outcomes of Tbi Patients Undergoing Craniotomy for Extra-axial Hematoma: A 2-year Experience at Kilimanjaro Christian Medical Centre-tanzania

Abstract Introduction: Traumatic brain injury (TBI) remains a major global health issue, particularly among young adults, with high rates of morbidity and mortality. Delays in surgical intervention can worsen secondary brain injuries. When performed promptly and appropriately, surgery significantly reduces mortality and morbidity. This study evaluated factors associated with unfavourable outcomes in patients with extra-axial hematomas at Kilimanjaro Christian Medical Centre (KCMC).Objective: To assess factors associated with unfavourable outcomes in TBI patients with extra-axial hematomas treated surgically at KCMC.Methodology: A retrospective study was conducted at a hospital using data from the KCMC TBI registry and general surgery operating theatre records. A total of 295 patients who received surgical treatment for extra-axial hematomas were included in the analysis. Clinical, radiological, and intraoperative information was examined using SPSS version 29.Results: The study included 295 participants, 92.9% of whom were male, with 89.5% aged 18–49 years. Mild TBI was the most common (50.8%), followed by severe (25.1%) and moderate (24.1%) TBI. Motor traffic accidents (MTAs) were the leading cause (72.9%). The mean Glasgow Coma Scale (GCS) on arrival was 11.4. Most patients (63.7%) had systolic blood pressure between 90–149 mmHg. Acute epidural hematomas (60.3%) were the most frequent, followed by subdural hematomas and intracerebral haemorrhages (36.6%). Additional injuries were present on CT scans in 67.5% of cases. At 3 months post-surgery, mortality was 18.3%, and unfavourable outcomes were noted in 28.5%.Factors significantly associated with poor outcomes included age ≥ 50 years (p < 0.002), early hospital arrival (p < 0.007), polytrauma, elevated systolic BP (p < 0.000), herniation syndromes, midline shift, and other CT abnormalities (p < 0.001.Conclusion: Craniotomy showed a positive impact on outcomes, but delays and secondary factors remain critical. Early referral, prompt triage, and adequate resuscitation are essential to improve outcomes. The findings highlight the need for tailored treatment approaches and strategies to minimize delays in TBI care.