Improving traumatic brain injury outcomes: The development of an evaluation and referral tool at Groote Schuur Hospital

Abstract Objectives In the Western Cape Province of South Africa there is a great shortage of diagnostic expertise, rehabilitative infrastructure and support services for traumatic brain injury (TBI) patients. The neurosurgical outpatient setting is busy and often chaotic, and patients are frequently lost to follow up. This study sought to continue with the design and development of a comprehensive, yet brief tool to aid patient referrals and ensure that no consequence of TBI is left unidentified and unaddressed. Methods Forty-seven TBI patients aged between 18 and 75 (mean = 35) were assessed. The study was designed around three distinct phases, each representing a different stage in the tool’s development. Results The Groote Schuur Traumatic Brain Injury Evaluation (GSH TBI-E) was shortened and simplified. Overall, 81% of the participants indicated cognitive dysfunction. There was a high prevalence of psychological/psychiatric sequelae, with 85% of participants reporting at least one such problem. Conclusion The findings further highlight the prevalence of the cognitive, behavioural and psychological consequences of TBI, and shed additional light on the particular types of problems that TBI patients face. Following the identified changes, the questionnaire and algorithm combination are now ready to be validated in the neurosurgical clinical setting.