Clinical Spectrum of Trauma at a University Hospital in Nigeria

Abstract

Background and Objectives: Data on trauma in Nigeria requires updating just as trauma care needs coordination and organization. This study was done to examine the clinical spectrum of trauma and to propose measures for organization of trauma care. Patients and Methods: A 2-year prospective report of an ongoing trauma research is presented. Data obtained from include name, age, sex, presenting diagnosis at the accident and emergency (A and E) unit, injury-arrival time, mode of transportation of patients to the hospital, and the outcome of care. Results: Trauma patients comprised 2,913 of the 4,164 (70.0%) surgical patients seen in the A and E but 129 of 171 deaths (75.4%). Types of trauma were lacerations (585 patients, 20.1%), fractures (542, 18.7%), head injury (250, 8.6%), multiple injuries (249, 8.6%), burns (159, 5.5%), and others. Road traffic accidents (RTA) occurred in 1,816 patients (62.3%), falls in 308, assaults in 258, burns in 159, home accidents in 122, gunshot injuries in 107, industrial accidents in 73, and foreign body injuries in 70. There was no pre-hospital care. Transport to the A and E was done by relations, the police and a few Good Samaritans. Most of the patients reached the hospital in < 6 h. Common mortalities were from head injury (37 patients, 28.7%), multiple injuries (35, 27.1%), fractures (12, 9.3%), and burns (9, 7.0%). Of 106 deaths with timed records, 22 (20.7%), 56 (53.0%) and 28 (26.3%) occurred in 0-1 h, > 1-24 h and > 24 h, respectively. Conclusions: The spectrum of trauma is predominantly RTA-related, hence, trauma care organization would include prevention of RTA, organization of pre-hospital care aimed at transport time of < 2 h, training volunteers from the populace and the police as emergency medical services technicians for resuscitation during transport and getting patients to hospital in optimal state, and an enhanced in-hospital care by designation and categorization of hospitals. These strategies, including continuous trauma research and funding, would go a long way in reducing mortalities from trauma, especially from RTA.

Trauma in a Teaching Hospital Outpost: Comprehensive Health Centre, Okoyong, Cross River State, Nigeria

“…The victims of the mass casualty involving two buses that conveyed traders and foodstuff were managed primarily at the health center. Other studies portray a similar experience, with the highest figure of 90.6% reported by Thanni and Kehinde [6] and 62.3% reported by Solagberu et al [7] in Nigeria. In Kenya, 31% was recorded [8] and 19% was recorded in the Netherlands [9].…”

Clinical spectrum of discharges against medical advice in a developing country

“…In this study trauma accounted for (97.2%) while long bone fracture was the most common diagnosis in patients that DAMA (51%). This is because trauma is the most common reason for patients being admitted in surgical emergency as shown by Solagberu et al [11]. Perhaps our people have faith in the traditional bone setters than in the orthodox medical practice.…”

Trauma admissions to the ICU of a tertiary hospital in a low resource setting

“…These problems have contributed to high trauma related morbidity and mortality in the country. 8 Trauma patients represent the majority of surgical patients presenting in the Accident and Emergency Units of most Nigerian tertiary hospitals, and a leading cause of accidental death in the country 9 . Major trauma was the commonest reason for admission to the ICU of another tertiary hospital located in south western Nigeria 10 .…”