Hospital Mortality FollowingTrauma: An Analysis of a Hospital-Based Injury Surveillance Registry in sub-SaharanAfrica
Journal – Journal of Surgical Education
Publication date – Jul – 2015
Authors – Anna F.Tyson MD, Carlos Varela MBChB, Bruce A.Cairns MD, AnthonyG.Charles MD
Keywords – developing health care systems, trauma, trauma mortality, trauma sub-Saharan Africa
Open access – Yes
Speciality – Neurosurgery, Trauma and orthopaedic surgery
World region Central Africa, Eastern Africa, Middle Africa, Southern Africa, Western Africa
Language – English
Submitted to the One Surgery Index on July 31, 2018 at 12:31 am
IMPORTANCE: Injuries are a significant cause of death and disability, particularly in low- and middle-income countries. Health care systems in resource-poor countries lack personnel and are ill equipped to treat severely injured patients; therefore, many injury related deaths occur after hospital admission.
OBJECTIVES: This study evaluates the mortality for hospitalized trauma patients at a tertiary care hospital in Malawi.
DESIGN: This study is a retrospective analysis of prospectively collected trauma surveillance data. We performed univariate and bivariate analyses to describe the population and logistic regression analysis to identify predictors of mortality.
SETTING: Tertiary care hospital in sub-Saharan Africa.
PARTICIPANT: Patients with traumatic injuries admitted to Kamuzu Central Hospital between January 2010 and December 2012.
MAIN OUTCOME MEASURES: Predictors of in-hospital mortality.
RESULTS: The study population consisted of 7559 patients, with an average age of 27 years (18 years) and a male predominance of 76%. Road traffic injuries, falls, and assaults were the most common causes of injury. The overall mortality was 4.2%. After adjusting for age, sex, type and mechanism of injury, and shock index, head/spine injuries had the highest odds of mortality, with an odds ratio of 5.80 (2.71-12.40).
CONCLUSION AND RELEVANCE: The burden of injuries in sub-Saharan Africa remains high. At this institution, road traffic injuries are the leading cause of injury and injury-related death. The most significant predictor of in-hospital mortality is the presence of head or spinal injury. These findings may be mitigated by a comprehensive injury-prevention effort targeting drivers and other road users and by increased attention and resources dedicated to the treatment of patients with head and/or spine injuries in the hospital setting.
OSI Number – 10202
PMID – 25451718