Maximizing the potential of trauma registries in low-income and middle-income countries

Rosenkrantz, Leah; Schuurman, Nadine; Arenas, Claudia Marcela; Nicol, Andrew; Hameed, Morad

doi:10.1136/tsaco-2020-000469

Cited by 21 publications

(14 citation statements)

References 44 publications

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“…An example of this is the Kampala Trauma Score (KTS), a validated trauma Injury Severity Score (ISS) adapted for LMIC countries. It differs from the ISS and Revised Trauma Score (RTS), which require more complex calculations and have age specifications that are more in sync with higher-income countries [ 44 ]. Efficient compilation of injury data that are simple and standardised across the trauma system is vital for decision-making, health policy formulation, and budgetary planning for a trauma system [ 45 ].…”

Section: Reviewmentioning

confidence: 99%

Trauma Care in Nigeria: Time for an Integrated Trauma System

Okereke¹,

Zahoor²,

Ramadan³

2022

Cureus

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Traumatic injuries are a global health problem. Most first world countries have developed comprehensive trauma systems to provide optimal care for injured patients. A trauma system is a coordinated effort in a defined geographic area that attempts to deliver trauma care to all injured patients and is usually integrated with the local public health system. The majority of low and middle income countries (LMIC) do not have functional trauma systems. This study aims to critique the status of trauma care in Nigeria and make a case for a re-organisation towards an inclusive trauma system. The methodology was a review of published articles and available grey literature to assess current practices in Nigeria within the various components of a trauma system, viz., injury prevention, pre-hospital care, acute care, and rehabilitation. The conclusions from this review suggest that integrating existing major trauma centres (MTCs) with smaller local hospitals within a region into an inclusive, interconnected region-based trauma system is the cheapest and most efficient way to improve Nigeria's trauma care and significantly reduce trauma mortality rates.

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Section: Reviewmentioning

confidence: 99%

Trauma Care in Nigeria: Time for an Integrated Trauma System

Okereke¹,

Zahoor²,

Ramadan³

2022

Cureus

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“…A questionnaire with trauma registry stewards in LMICs showed a need to "develop skills at political lobbying to induce support from the administration" to provide a platform for long-term aid [33 p.2221]. The lack of common guidelines was highlighted as a barrier [9,24,25,33,38,40]. A study exploring staff trauma experiences in LMICs underlined that organisational diversity across the region led to limited uniform policies which reduced communication among trauma facilities [9].…”

Section: Domain 2: Outer Settingmentioning

confidence: 99%

Facilitators and barriers impacting in-hospital Trauma Quality Improvement Program (TQIP) implementation: A scoping review on the implementation of TQIPs across income levels

Kapanadze

Berg

Sun

et al. 2022

Preprint

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Background Trauma describes physical injury along with the bodies associate reponse, and is a leading cause of mortality and morbidity globally, with low and middle income countries (LMICs) disproportionately affected. Understanding the implementation of in-hospital Trauma Quality Improvement Programs (TQIPs) and the factors determining success is critical to reduce the global trauma burden. The purpose of the review was to identify key facilitators and barriers to TQIP implementation across income levels by evaluating the range of literature on the topic. Methods We used information sources PubMed, Web of Science, and Global Index Medicus. The eligibility criteria was English language studies, of any design, published from June 2009 - January 2022. The Preferred Reporting Items of Systematic Reviews and Meta-Analyses checklist extension for scoping reviews were used to carry out a three-stage screening process. Content analysis using the Consolidated Framework for Implementation Research (CFIR) identified facilitator and barrier themes for in-hospital TQIP implementation. Results Twenty-eight studies met the eligibility criteria from 3923 studies. The main facilitators and barriers identified were the need to prioritise staff education and training, strengthen dialogue with stakeholders, and provide standardised best-practice guidelines. Data quality improvements were more apparent in LMICs while high-income countries (HICs) emphasised increased communication training. Conclusions Stakeholder prioritisation of in-hospital TQIPs, along with increased knowledge and consensus on trauma care best practice will further advance efforts to lower the global trauma burden. The focus of future in-hospital TQIPs in LMICs should primarily be concerned with improving data quality of registries, while interventions in HICs should focus on communication skills of healthcare professionals.

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“…These registries provide valuable data for injury surveillance, health system development and resource allocation. Even though the burden of such injuries is higher in LMIC’s, the adoption and implementation of these registries has lagged behind [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Use of a trauma registry to drive improvement in the regional trauma network systems in Hawassa, Ethiopia

Mengesha

Vella

Adem

et al. 2022

Eur J Orthop Surg Traumatol

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Aim Our aim is to establish and analyse the first year of trauma registry data from Hawassa University Comprehensive Specialised Hospital (HUCSH)—an Ethiopian tertiary referral centre. We plan to identify possible trends in injury patterns, access to health care and referral pathways and establish if our observations are in keeping with data published from other sub-Saharan LMIC’s. Methods Prospective data collection using the WHO trauma registry dataset. All trauma patients presenting to HUCSH between November 2019 and November 2020 were included. Military patients were excluded. Dataset: Age, sex, region of residence, mode of transport to hospital, referral centre, time from injury to arrival in HUCSH, arrival triage category, Kampala Trauma Score (KTS), mechanism of injury, injury type, closed/open fracture and 24 h outcomes. Data statistical analysis was performed to calculate frequencies of the above variables. Results There were a total of 1919 cases. Fifty-three per cent were caused by road traffic collision and 49% were fracture/dislocations. Public transport was the most common mode to hospital—40%. Seventy-seven per cent of all trauma admissions were referred from other centres, 69% had a mild KTS. A total of 376 patients presented with an open fracture—76% had a low KTS and 67% remained in ED for > 24 h. Sixty-five per cent of ambulances were utilised for mild KTS patients, only 25% of ambulances transported moderate and severe injuries. Conclusion We have shown that a ‘one size fits all approach’ should not be adopted for LMIC’s as trends vary between regions and countries. Improvements are needed in ambulance utilisation, the use of appropriate triaging tools to facilitate initial basic trauma care and appropriate, timely referrals and the management of open fractures.

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Maximizing the potential of trauma registries in low-income and middle-income countries

Cited by 21 publications

References 44 publications

Trauma Care in Nigeria: Time for an Integrated Trauma System

Trauma Care in Nigeria: Time for an Integrated Trauma System

Facilitators and barriers impacting in-hospital Trauma Quality Improvement Program (TQIP) implementation: A scoping review on the implementation of TQIPs across income levels

Use of a trauma registry to drive improvement in the regional trauma network systems in Hawassa, Ethiopia

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