The Hybrid Electronic Medical Registry Allows Benchmarking of Quality of Trauma Care: A Five‐Year Temporal Overview of the Trauma Burden at a Major Trauma Centre in South Africa

Donovan, M M; Kong, Victor; Bruce, John; Laing, G L; Bekker, W; Manchev, V; Smith, M T D; Clarke, Damian

doi:10.1007/s00268-018-04880-1

Cited by 23 publications

(33 citation statements)

References 22 publications

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“…All patients aged ≥65 years who were admitted to the PMTS following trauma between December 2012 and January 2019 were identified from the HEMR. [6] Basic demographic data regarding the mechanism and severity of the injuries were reviewed. Clinical outcomes were assessed.…”

Section: The Studymentioning

confidence: 99%

“…It provides trauma care to the city of Pietermaritzburg with its population of one million people and tertiary trauma care to the predominantly rural western third of KwaZulu-Natal (KZN) Province. [6] This is a large geographical area served by 19 district hospitals and 2 regional hospitals, with a population of 2 million people. [6] The PMTS is one of the largest academic trauma centres in western KZN.…”

mentioning

confidence: 99%

“…[6] This is a large geographical area served by 19 district hospitals and 2 regional hospitals, with a population of 2 million people. [6] The PMTS is one of the largest academic trauma centres in western KZN. A digital database known as the Hybrid Electronic Medical Registry (HEMR) captures data on all patients admitted to the trauma centre.…”

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confidence: 99%

“…A digital database known as the Hybrid Electronic Medical Registry (HEMR) captures data on all patients admitted to the trauma centre. [6] Ethics approval for maintenance of the registry and for this study was This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.…”

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confidence: 99%

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A review of geriatric injuries at a major trauma centre in South Africa

et al. 2019

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Trauma in South Africa (SA) has aptly been referred to as a 'malignant epidemic' . [1,2] It places a massive burden on society as a whole as well as on the healthcare system. SA, like many low-to middle-income countries (LMICs), is considered to be a 'young' country with a population pyramid weighted heavily towards people <40 years of age. [3,4] Focus has been placed on improving outcomes for children and young people. Maternal and child health and the antiretroviral programme have dominated health policy and have absorbed much health funding. [3] This situation is gradually changing. As infectious disease is brought under control, there is growing awareness of the burden of non-communicable disease. [1,5] Surgical diseases contribute significantly to the overall burden of non-communicable disease, and trauma is a major surgical disease. Trauma is traditionally thought of as affecting young people. While this is true for the most part, certain vulnerable groups deserve special attention. Much has been published on the burden of trauma in SA over the past half century. Despite this extensive literature, however, children, women and the elderly are relatively under-represented and under-researched. ObjectivesThe impact of trauma on the elderly has tended to be overlooked, and the objective of this study was to address this deficit by focusing on trauma victims aged ≥65 years. Methods Clinical settingThe Pietermaritzburg Metropolitan Trauma Service (PMTS) is based at Grey's Hospital in the city of Pietermaritzburg, SA. It provides trauma care to the city of Pietermaritzburg with its population of one million people and tertiary trauma care to the predominantly rural western third of KwaZulu-Natal (KZN) Province. [6] This is a large geographical area served by 19 district hospitals and 2 regional hospitals, with a population of 2 million people. [6] The PMTS is one of the largest academic trauma centres in western KZN. A digital database known as the Hybrid Electronic Medical Registry (HEMR) captures data on all patients admitted to the trauma centre. [6] Ethics approval for maintenance of the registry and for this study was This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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Section: The Studymentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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A review of geriatric injuries at a major trauma centre in South Africa

et al. 2019

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“…This suggests that the HEMR is a reliable tool and is capturing data appropriately. 10,12 As HEMR continues, it is hoped that it will be able to continue to generate accurate and useful data. The spectrum of injuries related to assault with a knife is diverse with the head and neck, the chest and the abdomen being the body regions most frequently injured.…”

Section: Discussionmentioning

confidence: 99%

The scourge of knife crime: trends in knife-related assault managed at a major centre in South Africa

Uchino¹,

Kong²,

Pantelides³

et al. 2020

S. Afr. j. surg.

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Predicting the Outcome of Non‐operative Management of Splenic Trauma in South Africa

et al. 2020

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Introduction We aimed to expand on the global surgical discussion around splenic trauma in order to understand locally and clinically relevant factors for operative (OP) and non-operative management (NOM) of splenic trauma in a South African setting. Methods A retrospective cohort study was performed using 2013-2017 data from the Pietermaritzburg Metropolitan Trauma Service. All adult patients (C15 years) were included. Those managed with OP or NOM for splenic trauma were identified and analyzed descriptively. Multiple logistic regression analysis identified patients and clinical factors associated with management type. Results There were 127 patients with splenic injury. Median age was 29 [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] years with 42 (33%) women and 85 (67%) men. Blunt injuries occurred in the majority (81, 64%). Organ Injury Scale (OIS) grades included I (25, 20%), II (43, 34%), III (36, 28%), IV (15, 11%), and V (8, 6%). Nine patients expired. On univariate analysis, increasing OIS was associated with OP management, need for intensive care unit (ICU) admission, and hospital and ICU duration of stay, but not mortality. In patients with a delayed compared to early presentation, ICU utilization (62% vs. 36%, p =0 . 0 0 8 ) and mortality (14% vs. 4%, p = 0.03) were increased. After adjusting for age, sex, presence of shock, and splenic OIS, penetrating trauma (adjusted odds ratio, 5.7; 95%CI, 1.7-9.8) and admission lactate concentration (adjusted odds ratio, 1.4; 95%CI 1.1-1.9) were significantly associated with OP compared to NOM (p = 0.002; area under the curve 0.81). Conclusions We have identified injury mechanism and admission lactate as factors predictive of OP in South African patients with splenic trauma. Timely presentation to definitive care affects both ICU duration of stay and mortality outcomes. Future global surgical efforts may focus on expanding non-operative management protocols and improving pre-hospital care in patients with splenic trauma.

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The Hybrid Electronic Medical Registry Allows Benchmarking of Quality of Trauma Care: A Five‐Year Temporal Overview of the Trauma Burden at a Major Trauma Centre in South Africa

Cited by 23 publications

References 22 publications

A review of geriatric injuries at a major trauma centre in South Africa

A review of geriatric injuries at a major trauma centre in South Africa

The scourge of knife crime: trends in knife-related assault managed at a major centre in South Africa

Predicting the Outcome of Non‐operative Management of Splenic Trauma in South Africa

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