Surgical profile and in-hospital outcomes of traumatic brain injury at a tertiary hospital in Luanda, Angola

Background Operative neurotrauma data from Angola are sparse, and the operated subgroup of hospital traumatic brain injury (TBI) cohorts has not been described. Objective To quantify operative workload in a hospital TBI cohort and describe diagnoses, techniques and in-hospital outcomes. Methods Retrospective single-center cohort at the Neurosurgery Service of Hospital do Prenda, Luanda. Admissions for TBI between January 2021 and December 2025 yielded 578 patients after removal of duplicates, of whom 192 underwent surgery. Diagnosis and technique labels were harmonized. The outcome was in-hospital death versus survival to discharge; proportions use Wilson 95% confidence intervals (CI) and severity was compared with the exact Freeman-Halton test. Results Of 578 patients, 192 (33.2%) were operated on; median age 29 years, 84.4% male. Diagnoses were subdural hematoma (79; 41.1%; 38 chronic), skull fracture (65; 33.9%; 54 depressed) and epidural hematoma (33; 17.2%). Technique was classifiable in 148 (77.1%; 95% CI 70.6–82.5), chiefly sequestrectomy (56), burr hole or trephination (33) and craniotomy (30). Twenty-two patients died (11.5%; 95% CI 7.7–16.7) and 166 (86.5%) were alive at discharge. Severity was recorded in only 38 patients (19.8%); mortality was 0/5 in mild, 0/14 in moderate and 11/19 (57.9%; 95% CI 36.3–76.9) in severe TBI ( p < 0.001). Conclusions Surgery was concentrated on subdural hematoma, skull fracture and epidural hematoma. Crude in-hospital mortality was 11.5% and, among patients with recorded severity, deaths occurred only with severe TBI. Missing severity and technique data, absent functional follow-up and unavailable treatment-time intervals limit these findings to short-term survival.