Developing a low-resource approach to trauma patient care - findings from a nigerian trauma registry

Abstract

Background: Trauma is a worldwide problem that results in significant morbidity and mortality in developing countries. Objective: This study looks at the demography of trauma from data abstracted from a Nigerian trauma registry and considers the peculiarities of a low-resource setting from this perspective. Methods: Trauma registry data from January 2013 to June 2014 were analyzed. Results: A total of 542 patients were included in the study. The mean age of the patients was 33.43 ± 12.79 years; the median time from injury to arrival at the hospital was 3 h (interquartile range IQR 1 – 5.1 h); three-quarters of the patients sustained their injuries on the road-tricycles were rarely involved in road traffic injuries (RTIs) (6.9% of RTIs) but were used in transporting a third of the patients whose data on means of transportation were captured. There were 15 (2.7%) deaths in the first 24 h period postinjury covered by the study – 13 (86.7%) of these patients had head-and-neck injury. About half of the assault injury (50.5%) was from persons known to the victim. The shock indices suggested that a majority of the patients were not at a high risk of mortality. Conclusion: Most of the trauma patients at our hospital were in low- to middle-income categories. The median time to arrival of injured patients was 3 h (IQR 1 – 6 h). Most injuries occurred on the road because of RTIs. The involvement of tricycles in accidents was uncommon, but they were used fairly commonly by lay responders in transporting the injured victim to hospital. A high proportion of assailants were known to the victim. The use of trauma registries provides essential data for prioritizing limited resources and can guide a contextualized approach to reducing trauma and improving trauma patient care.

Management of Ankle Fractures – A Survey of Practices of Orthopaedic Surgeons in Nigeria

“…21 A review of trauma registry data revealed that injured patients arrive at the emergency department in a median time of 3 hours. 22 This was in keeping with a finding by Malomo et al, where about half of the head injured patients presented within 12 hours. 23 While our data was not specific about time to arrival, the delayed / late arrival of patients with ankle fractures in the opinion of more than two-thirds of our cohort, may be due to the injury usually not being life or limb threatening, which appears to afford time to source for funds, or due to the tendency to resort to TBS for initial care of injuries.…”

Review of a large trauma registry in Addis Ababa, Ethiopia: insights into prehospital care and provider training for trauma quality improvement

“… 18 Similarly in Nigeria, a high proportion of patients were transported to trauma centers by laypersons with long transport times. 19 The pattern of a high proportion of road traffic accidents and intracranial injuries among those seriously injured was also seen in a recent study in Tanzania using data from the WHO model trauma registry. 20 In cases of seriously injured patients with head injury, rapid transport to a trauma center with highest level of care provides the best opportunity for survival.…”

Trauma provision in South-West Nigeria: Epidemiology, challenges and priorities

“…A potential solution to the drawbacks of collecting injury surveillance data is the concept of minimum data set as recommended by the Centres for Disease Control and Prevention (CDC) [52] . This concept ensures that only essential information are captured and was utilised in the development of the Kampala TR form and more recently in Nigeria, the Uyo TR form [ 53 , 54 ]. These existing TRs should be adapted by the hospitals within the region and subsequently pooled into the regional trauma registry.…”