Trauma Admissions in the Southern Highlands of Papua New Guinea

Abstract

Background: Trauma is a common cause of surgical admission in Papua New Guinea (PNG) but to date there has been no study of the whole trauma burden in provincial hospitals. Methods: A I-year retrospective study was made of all surgical admissions to the provincial hospital at Mendi. Results: Trauma was the third commonest reason for hospital admission and accounted for 43% of all surgical cases. The common causes of injury were tribal fights (24%). domestic violence (14.3%). assault (16.7%). road accidents (14%) and domestic accidents (25.1%). which comprised falls, penetrating wounds and bites. Males accounted for two-thirds of cases, and 19% were children below the age of 16. Only eight of 454 patients died (1.8%). because most trauma deaths occur before the patient reaches hospital. There were only 37 multiple injuries and only five patients had an injury severity score of greater than 16. The average inpatient stay for trauma admissions was 10.6 days. Conclusions:The cost of trauma in Mendi is difficult to calculate, but is enormous. In addition to 11% of the recurrent hospital expenditure (over US$ I. 1 million, excluding pharmaceuticals), the community costs include loss of earnings and productivity, as well as permanent disability. The social disruption caused by tribal fights results in cessation of the local economy, burning of aid posts, schools and homes and destruction of gardens for subsistence farming. Those who reach hospital alive tend to have single injuries and survive.

Burden of road traffic injuries and related risk factors in low and middle-income Pacific Island countries and territories: a systematic review of the scientific literature (TRIP 5)

“…One study was published in two journals [41,42], so the study with less information was excluded [42]. Fifteen studies were case series; including ten studies identifying cases from retrospective records [23-26,28,29,31,32,35,37], three studies from prospective records [27,30,36], and two studies from both retrospective and prospective records [33,34]. There were three ecological studies [38-40], and one study was a case control study [41].…”

“…Studies suggest RTIs were responsible for 14–30% of trauma admissions [32,34], 49% of head injury admissions [33], 10% of abdominal trauma admissions [36], and 34% of trauma-related spinal cord injury hospital admissions [26]. The average length of stay was usually longer for RTIs compared to other trauma-related injuries with variations between hospitals (Mendi = 10 days, PMGH = 26 days) [32,34].…”

“…The average length of stay was usually longer for RTIs compared to other trauma-related injuries with variations between hospitals (Mendi = 10 days, PMGH = 26 days) [32,34]. …”

The parry problem

“…Finally, skeletal injuries represent no more than 40% of all injuries acquired during assaults (e.g., Geldermalsen, 1993;Matthew et al, 1996). Soft tissue injuries due to cuts, bruising and more fatal internal damage are invisible and as a result any bioarcheological interpretation of interpersonal or external interpersonal violence, or the lack of it, will always be underestimated no matter how many parry fractures are present.…”

A Comparison of the Kampala Trauma Score (KTS) with the Revised Trauma Score (RTS), Injury Severity Score (ISS) and the TRISS Method in a Ugandan Trauma Registry

“…However, it has been inadequately studied in developing countries [3]. Retrospective reviews of injury pattern and severity have been performed in health care settings [4][5][6][7]. However, these studies have only scratched the surface of the magnitude and extent of injury for developing countries.…”