Traumatic brain injury in underage motorbike drivers: clinical outcomes, and socio-cultural attitudes from a lower-middle-income country

Ashraf, M., Kamboh, U. A., Hussain, S. S., Raza, M. A., Mehboob, M., Zubair, M., Ahmad, M. and Ashraf, N. (2022) Traumatic brain injury in underage motorbike drivers: clinical outcomes, and socio-cultural attitudes from a lower-middle-income country. World Neurosurgery, 167, e413-e422. (doi: 10.1016/j.wneu.2022.08.027) (PMID:35964900)

Abstract

Background And Objectives: Poor societal attitudes and inadequate law enforcement have greatly contributed to the increase in underage motorbike driving in Pakistan. This study reports the burden of traumatic brain injury (TBI), clinical characteristics/outcomes, and reason for driving in underage motorbike drivers. Materials And Methods: Prospective study throughout 2021. Demographics, mechanism of injury, helmet-use, number of passengers, clinical outcomes, reason for driving and parental awareness/consent status, referral pathway and transport duration were documented. Results: 112 underage motorbike drivers were studied (from 1,052 total). The mean age was 14.7 years (range 10 -17). 98.2% were male, and 17% wore protective helmets. The most common reason for driving was recreational, followed by domestic chores. In 66 cases, there was parental awareness, of which 30 had active parental consent. These cases were associated with domestic chores as the reason for their journey, whilst recreational purposes were a more prevalent reason in cases without parental awareness/consent (p<0.001). Most patients were brought by provincial ambulance service (response time 12.8 minutes). A segment of patients came from peripheral hospitals (26.8%) and private hospitals (14.3%), both lacking neurosurgical cover, and these were associated with severer baseline injuries (P<0.001). The average stay was 6.5 days, and 75.9% of patients were discharged with a good Glasgow Outcome Score. Conclusion: Underage motorbike driving TBI patients are adolescent boys who don’t use helmets. Trauma prevention systems and involvement of multiple stakeholders is needed to reduce underage driving. Efficient referral systems must transport patients to appropriate neurosurgical cover, which is lacking outside major cities.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: UNSPECIFIED
• Authors: Ashraf, M., Kamboh, U. A., Hussain, S. S., Raza, M. A., Mehboob, M., Zubair, M., Ahmad, M., and Ashraf, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: World Neurosurgery
• Publisher: Elsevier
• ISSN: 1878-8750
• ISSN (Online): 1878-8769
• Published Online: 11 August 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in World Neurosurgery 167: e413-e422
• Publisher Policy: Reproduced under a Creative Commons License