TITLE:
Traumatic Brain Injury Managed through the Neurosurgical Pathway at Bouaké Teaching Hospital, Côte d’Ivoire: Profile and Determinants of In-Hospital Mortality in a Cohort of 772 CT-Confirmed Patients
AUTHORS:
Faozo Stephane Landry Teti, Aymar Louis Keableon Derou, Koffi Yves Soress Dongo, Konan Serge Yao, Yao Bernard Fionko, Aderehime Haidara
KEYWORDS:
Craniocerebral Trauma, Traffic Accidents, Epidemiology, Glasgow Coma Scale, Côte d’Ivoire
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.16 No.4,
September
28,
2026
ABSTRACT: Background: Traumatic brain injury is a leading cause of death and acquired disability among young people in sub-Saharan Africa, where motorcycle transport has expanded faster than prevention. Ivorian data remain fragmentary. The objective was to describe the epidemiological and lesional profile of CT-confirmed traumatic brain injury managed through the neurosurgical pathway at Bouaké Teaching Hospital and to identify determinants of in-hospital mortality and functional outcome. Methods: Single-centre observational cohort of 772 consecutive CT-confirmed patients admitted through the neurosurgical pathway between January 2025 and June 2026, assembled by retrospective analysis of the neurosurgical department register and reported according to STROBE. Fisher exact test; Firth penalized logistic regression with profile-likelihood confidence intervals. Results: Patients were mainly young men (mean age 33.9 years; 83.8% male) injured in road-traffic crashes (89.4%), almost all involving two- or three-wheeled motorised vehicles; helmet use among documented users was 5.4%. Most injuries were mild (56.2%), with severe forms accounting for 7.9%. In-hospital mortality was 4.7% (36 deaths) and functional outcome favourable in 94.5%. After adjustment, depth of coma was the only independent determinant of mortality: each Glasgow point lost multiplied the odds of death by 1.56 (95% CI: 1.31 - 1.86). Age, helmet non-use and admission delay beyond 48 hours were not associated with mortality. Conclusion: Initial neurological severity dominates in-hospital outcome. Very low helmet use identifies primary prevention as the most accessible lever.