Diagnostic value of abdominal ultrasonography in patients with blunt abdominal trauma

Nnamonu, Michael Ikechukwu; Ihezue, C H; Sule, A Z; Ramyil, VM; Pam, Sunday

doi:10.4103/1117-6806.119243

Cited by 5 publications

(1 citation statement)

References 13 publications

(15 reference statements)

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“…Task shifting of eFAST from radiologists to primary trauma care providers may alleviate access barriers due to limited specialist training [35][36][37][38]. Several LMIC studies have demonstrated promising educational efficacy of context-adapted training programs in teaching small clinician cohorts to perform point-of-care ultrasonography, including eFAST, in Rwanda, Nigeria, Sierra Leone and Uganda [39][40][41][42]. Conventional ultrasound machines are expensive and scarce in Cameroon, likely contributing to the 2% rate of injured patients who received ultrasound among our cohort.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Failure to receive prescribed imaging is associated with increased early mortality after injury in Cameroon

Driban,

Dissak-Delon,

Carvalho

et al. 2023

PLOS Glob Public Health

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Despite having the highest rates of injury-related mortality in the world, trauma system capacity in sub-Saharan Africa remains underdeveloped. One barrier to prompt diagnosis of injury is limited access to diagnostic imaging. As part of a larger quality improvement initiative and to assist priority setting for policy makers, we evaluated trauma outcomes among patients who did and did not receive indicated imaging in the Emergency Department (ED). We hypothesize that receiving imaging is associated with increased early injury survival. We evaluated patterns of imaging performance in a prospective multi-site trauma registry cohort in Cameroon. All trauma patients enrolled in the Cameroon Trauma Registry (CTR) between 2017 and 2019 were included, regardless of injury severity. Patients prescribed diagnostic imaging were grouped into cohorts who did and did not receive their prescribed study. Patient demographics, clinical course, and outcomes were compared using chi-squared and Kruskal-Wallis tests. Multivariate logistic regression was used to explore associations between radiologic testing and survival after injury. Of 9,635 injured patients, 47.5% (4,574) were prescribed at least one imaging study. Of these, 77.8% (3,556) completed the study (COMPLETED) and 22.2% (1,018) did not receive the prescribed study (NC). Compared to COMPLETED patients, NC patients were younger (p = 0.02), male (p<0.01), and had markers of lower socioeconomic status (SES) (p<0.01). Multivariate regression adjusted for age, sex, SES, and injury severity demonstrated that receiving a prescribed study was strongly associated with ED survival (OR 5.00, 95% CI 3.32–7.55). Completing prescribed imaging was associated with increased early survival in injured Cameroonian patients. In a resource-limited setting, subsidizing access to diagnostic imaging may be a feasible target for improving trauma outcomes.

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