Prevalence of ICD‑11–defined head injury and associated factors among trauma patients at a referral hospital in Oromia, Ethiopia: a hospital‑based cross‑sectional study

Background: Traumatic Brain Injury (TBI) has been a major global health issue and a leading cause of trauma-associated morbidity and death. Low- and middle-income countries (LMICs) bear a disproportionate burden due to the high incidence of road traffic crashes in these countries and the low emergency care capacity. In Ethiopia, there is a paucity of local data on head injury prevalence and the related factors. Objectives: To estimate the prevalence of head injury and determine the associated sociodemographic, behavioral, and head injury-related factors among trauma patients who presented to the emergency department of Ambo University referral hospital, Oromia, Ethiopia, from January to March 2023. Methods: A facility-based cross-sectional study was used with systematic random sampling. Head injury was defined according to ICD-11 codes NA00-NA0Z. Data were collected using tools adapted from WHO, entered into EpiData, and analyzed in SPSS v26. Associations were determined using multivariable logistic regression. Missing data (less than 5%) were excluded without data imputation. Sensitivity analysis was done to confirm the robustness of the findings by omitting alcohol and rural residence variables. Results: Among 266 eligible patients with trauma, 260 patients were analyzed (response rate of 97.7%). Head injury was diagnosed in 134 patients (51.5% 95% CI: 45.3-57.8). Male sex (AOR 2.75; 95% CI: 1.56-4.83), alcohol consumption before injury (AOR 4.33; 95% CI: 1.11-16.8), and road traffic crashes (AOR 2.24; 95% CI: 1.06-4.75) were found to be independently associated with head injury. Conclusion: Head injury made up more than half of trauma cases. Male sex, alcohol use before the injury, and road traffic crashes were significantly associated with head injury. These findings show interventions such as road safety enforcement and alcohol harm reduction should be given specific emphasis.