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Developing a Low-resource Approach to Trauma Patient Care - Findings from a Nigerian Trauma Registry
Timothy E Nottidge1, Bolanle A Nottidge2, Ifiok C Udomesiet1,3
1Department of Orthopaedics and Traumatology, University of Uyo Teaching Hospital, Akwa Ibom, Nigeria.
Background:
Trauma is a worldwide problem that results in significant morbidity and mortality in developing countries.
Objective:
This study looks at the demography of trauma from data abstracted from a Nigerian trauma registry and considers the peculiarities of a low-resource setting from this perspective.
Methods:
Trauma registry data from January 2013 to June 2014 were analyzed.
Results:
A total of 542 patients were included in the study. The mean age of the patients was 33.43 ± 12.79 years; the median time from injury to arrival at the hospital was 3 h (interquartile range IQR 1 - 5.1 h); three-quarters of the patients sustained their injuries on the road-tricycles were rarely involved in road traffic injuries (RTIs) (6.9% of RTIs) but were used in transporting a third of the patients whose data on means of transportation were captured. There were 15 (2.7%) deaths in the first 24 h period postinjury covered by the study - 13 (86.7%) of these patients had head-and-neck injury. About half of the assault injury (50.5%) was from persons known to the victim. The shock indices suggested that a majority of the patients were not at a high risk of mortality.
Conclusion:
Most of the trauma patients at our hospital were in low- to middle-income categories. The median time to arrival of injured patients was 3 h (IQR 1 - 6 h). Most injuries occurred on the road because of RTIs. The involvement of tricycles in accidents was uncommon, but they were used fairly commonly by lay responders in transporting the injured victim to hospital. A high proportion of assailants were known to the victim. The use of trauma registries provides essential data for prioritizing limited resources and can guide a contextualized approach to reducing trauma and improving trauma patient care.
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