Prevalence and factors associated with cerebral spinal fluid leakage among patients with traumatic brain injury at Mbarara regional referral hospital, Western Uganda

Abstract

Abstract Background Globally, the annual rate of head injury is estimated to be 27 million, with developing countries seen to have a higher prevalence. In Uganda head injury mortality and complications have been reported to be high in different centres. The complications of cerebral spinal fluid (CSF) leakage could be contributing to the poor outcome, though no study in Uganda has assessed its burden. This study aimed to determine the prevalence and factors associated of CSF leakage among patients with traumatic brain injury (TBI) at Mbarara Regional Referral Hospital (MRRH). Methods This was a sequential study at MRRH. All patients admitted with a diagnosis of TBI, irrespective of age or severity was included. Hallo test and Beta-transferrin test on Aural or nasal fluid were used for the diagnosis of CSF leakage. Logistic regression in SPSS version 26 was done to determine the significant factors. P < 0.05 was considered to be significant. Results In this study, we enrolled 317 participants. Majority (78.5%) were aged between 19 and 59 years. Majority (83.0%) were male. CSF leakage was confirmed in 23, representing a prevalence of 7.3%. In the multivariable analysis, the independent factors associated with CSF leakage were: having RTA as the mechanism of injury (aOR = 3.521, CI = 1.162–9.671, P = 0.002), presenting with a Glasgow coma scale < 15 (aOR = 3.468, CI = 1.319–9.120, P = 0.012) and CT findings suggestive of skull fracture (aOR = 13.35, CI = 4.33–41.13, P = < 0.001). Conclusion The prevalence CSF leak among TBI patients was relatively high as it was seen in almost 1 patient in every 10 cases. All patients that present with features suggestive of CSF leak should undergo testing to confirm. Measures to minimize cases of assault as well as minimizing severe impact should be embarked on by the peace keepers, to minimize the cases of CSF leak, as they increase mortality and morbidity.