Abstract

In the past decade, neurosurgery in Uganda experienced increasing surgical volume and a new residency training program. While research has examined surgical capacity, minimal data exists on the patient population treated by neurosurgery and their eventual outcomes in sub-Saharan Africa.Patients admitted to Mulago National Referral Hospital neurosurgical ward over two years (2014 and 2015) were documented in a prospective database. 1167 were discharged with documented phone numbers, thus eligible for follow-up. Phone surveys were developed and conducted in the participant's language to assess mortality, neurological outcomes, and follow-up healthcare.During the study period, 2032 patients were admitted to the neurosurgical ward, 80% for traumatic brain injury. 7.8% received surgical intervention. The in-hospital mortality rate was 18%. 870 patients were reached for phone follow-up, a 75% response rate. 30-day and 1-year mortality was 4% and 8%, respectively. Almost half of patients had not had subsequent healthcare after the initial encounter. Most patients had GOS-E scores consistent with good recovery and mild disability - trauma patients faring best and tumor patients faring worst. 85% felt they returned to baseline work performance, and 76% of guardians felt that children returned to baseline school performance.The neurosurgical service provided healthcare to a large proportion of non-operative patients. Phone surveys captured data on patients where nearly half would be lost to subsequent healthcare. While mortality during initial hospitalization was high, over 90% of those discharged survived at 1 year follow up, and the vast majority returned to work and school.

View details for PubMedID 29427813