Predictors of ICU admission and patient outcome for traumatic brain injury in a Tanzanian referral hospital: Implications for improving treatment guidelines

•We examined predictors of ICU admission and patient outcome in a sample of traumatic brain injury (TBI) patients admitted to a northern Tanzanian referral hospital.•Our study is among the first to assess the impact of surgery on patient outcome for TBI after disposition from an African ED.•Findings point to the need for targeted interventions among young men, improvements in pre-hospital transportation and care, and continued efforts to increase the quality of surgical and ICU care in Tanzania.•We provide guidance on future directions for the improvement of ED evaluation and referral to acute care in Africa, citing evidence-based guidelines from the Brain Trauma Foundation.