Prehospital transport of patients with spinal cord injury in Nigeria

Abstract

Background: A well-organized and efficient prehospital transport is associated with improved outcome in trauma patients. In Nigeria, there is paucity of information on prehospital transport of patients with spinal cord injury (SCI) and its relation to mortality. Objective: To determine if prehospital transportation is a predictor of mortality in patients with SCI in Nigeria. Design: Prospective cohort study Methods: Prehospital transport related conditions, injury arrival intervals and persons that brought patients with SCI to the casualty were noted. Data analyzed using descriptive statistics, the chi-square test and multiple logistic regressions. Main Outcome Measures: Mortality within 6 weeks on admission Results: 168 patients with SCI presented in the casualty during this review period. Majority (67.9%) presented after 24 hrs of the injury. Majority (58.3%) were conveyed into the casualty by their relatives. Salon car (54.2%) was the most common mode of transportation where majority (55.4%) laid on their back during the transfer. Majority (75%) of the patients had multiple hospital presentation before reporting in our casualty.The mortality observed was 16.7%. Multivariate analysis after adjusting for age, gender, and means of transportation revealed that age (OR= 63.41, 95% CI= 9.24-43.53), crouched position during transfer (OR= 23.52, presentation after 24 hrs (OR=5.48,) and multiple hospital presentation (OR= 7.94, 95% CI= 1.89-33.43) were associated with mortality within 6 weeks of admission. Conclusion: A well-organized and efficient prehospital transport would reduce mortality in spinal cord injured patients. Public enlightenment campaign on factors that could reduce road traffic injury would help reduce mortality.

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

“…There are no standby paramedics or emergency services in Tanzania for basic life support before and immediately on arriving at the hospital [20,21] therefore there is a high chance that severely injured individuals with TSCI die before they get to the hospital or at the emergence department before being admitted. Pre hospital mortality could also be due to delay of the injured person to be admitted to the appropriate health facility as in Nigeria [22] where a delay of up to 24 hours was reported. Those who die before investigations and admittance into the ward are normally not diagnosed with TSCI before death and this adds to the missed cases.…”

Mortality and Longevity after a Spinal Cord Injury: Systematic Review and Meta-Analysis

“…table; for all online suppl. material, see www.karger.com/doi/10.1159/000382079) [7,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107]. The study duration ranged from less than one year to more than 50 years, and included data beginning in 1935 until 2009.…”

Early Care following Traumatic Spinal Cord Injury (TSCI) in a Rehabilitation Centre in Bangladesh - An Analysis

“…In Pakistan, Rathore et al (2008) reported that 22.2% were evacuated by ambulance and the rest travelled in cars, jeeps and transport vehicles. In Nigeria, Ahidjo et al (2012) found that only 5.4% of the injured were transferred by ambulance, while Nguyen et al (2008) found this to be only 4% in Vietnam. In contrast, 93% of the injured in Sweden used the services of an ambulance (Divanoglou et al, 2010), and in Canada 41% were transported by ground ambulance, 54% by helicopter, and 5% by fixed-wing aircraft (Burney et al, 1989).…”