The characteristics and outcomes of trauma admissions to an adult general surgery ward in a tertiary teaching hospital

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The characteristics and outcomes of trauma admissions to an adult general surgery ward in a tertiary teaching hospital


JournalAfrican Journal of Emergency Medicine
Article typeJournal research article – Clinical research
Publication date – Apr – 2021
Authors – Alemayehu Ginbo Bedada, Margaret J. Tarpley , John L. Tarpley
KeywordsBotswana, Revised trauma score, trauma, Trauma admission, Trauma outcome
Open access – Yes
SpecialityGeneral surgery, Trauma surgery
World region Southern Africa
Country: Botswana
Language – English
Submitted to the One Surgery Index on May 2, 2021 at 3:41 am
Abstract:

Background
Traumatic injuries are proportionally higher in low- and middle-income countries (LMICs) than high-income counties. Data on trauma epidemiology and patients’ outcomes are limited in LMICs.

Methods
A retrospective review of medical records was performed for trauma admissions to the Princess Marina Hospital general surgical (GS) wards from August 2017 to July 2018. Data on demographics, mechanisms of injury, body parts injured, Revised Trauma Score, surgical procedures, hospital stay, and outcomes were analysed.

Results
During the study period, 2610 patients were admitted to GS wards, 1307 were emergency admissions. Trauma contributed 22.1% (576) of the total and 44.1% of the emergency admissions. Among the trauma admissions, 79.3% (457) were male. The median[interquartile range(IQR)](range) age in years was 30[24–40](13–97). The main mechanisms of injury were interpersonal violence (IPV), 53.1% and road traffic crashes (RTCs), 23.1%. More females than males suffered animal bites (5.9% vs. 0.9%), and burns (8.4% vs. 4.2%), while more males than females were affected by IPV (57.8% vs. 35.3%) and self-harm (5.5% vs. 3.4%). Multiple body parts were injured in 6.6%, mainly by RTCs. Interpersonal violence (IPV) and RTCs resulted in significant numbers of head and neck injuries, 57.3% and 22.2% respectively. More females than males had multiple body-parts injury 34.5% vs. 18.5%. Revised Trauma Score (RTS) of ≤11 was recorded in IPV, 38.4% and RTCs, 33.6%. Surgical procedures were performed on 44.4% patients. The most common surgical procedures were laparotomy (27.8%), insertion of chest tube (27.8%), and craniotomy/burr hole(25.1%). Complications were recorded in 10.1% of the patients(58) including 39 deaths, 6.8% of the 576.

Conclusion
Trauma contributed significantly to the total GS and emergency admissions. The most common mechanism of injury was IPV with head and neck the most frequently injured body part. Further studies on IPV and trauma admissions involving paediatric and orthopaedic patients are warranted.

OSI Number – 21075

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