Analysis of Prospective Trauma Registry Data in Francophone Africa: A Pilot Study from Cameroon
Analysis of Prospective Trauma Registry Data in Francophone Africa: A Pilot Study from Cameroon
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DOI：
10.1007/s00268-014-2604-1
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发表时间：
2014-10-01
影响因子：
2.6
通讯作者：
Hyder, Adnan A.
中科院分区：
文献类型：
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作者：
Juillard, Catherine J.;Stevens, Kent A.;Hyder, Adnan A.
撒哈拉以南非洲的伤害率是世界上最高的之一，但喀麦隆基于登记的前瞻性报告有限。我们的目标是创建一个预期的创伤登记，以扩展在喀麦隆雅温得一个繁忙的第三级中心收集的关于伤害的数据元素。由训练有素的研究助理使用结构化问卷在6个月的时间内从急诊科(ED)收集关于伤害的背景、呈现、护理、费用和处置的详细信息。建立了双变量和多变量模型来探索变量关系和结果。6个月内有2855名受伤患者，几乎占急诊室就诊总数的一半。平均年龄为30岁；73%为男性。致伤原因为道路交通伤占59%，坠落伤占7%，穿透伤占6%，动物咬伤占4%。其中，1,974人(69%)已出院，517人(18%)被送往手术室，14人(1%)被送往重症监护病房。身体损伤最严重的部位是骨盆和四肢(43%)，头部(30%)，胸部(4%)，腹部(3%)。估计损伤严重程度评分(EISs)：9分占60%，9-24分占35%，25分占2%。死亡率为0.7%。在多变量分析中，死亡率的独立预测因素是EIS的千分之9和格拉斯哥昏迷评分的千分之12。道路交通伤害是需要手术的独立预测因素。创伤登记结果被提交给喀麦隆卫生部，促使成立了国家伤害委员会。创伤占雅温得急诊和外科服务利用的很大比例。前瞻性的方法可以提供更广泛的信息。来自预期创伤登记的全面数据可以成功地用于倡导预防和治疗伤害的政策。
Injury rates in sub-Saharan Africa are among the highest in the world, but prospective, registry-based reports from Cameroon are limited. We aimed to create a prospective trauma registry to expand the data elements collected on injury at a busy tertiary center in Yaound, Cameroon.Details of the injury context, presentation, care, cost, and disposition from the emergency department (ED) were gathered over a 6-month period, by trained research assistants using a structured questionnaire. Bivariate and multivariate models were built to explore variable relationships and outcomes.There were 2,855 injured patients in 6 months, comprising almost half of all ED visits. Mean age was 30 years; 73 % were male. Injury mechanism was road traffic injury in 59 %, fall in 7 %, penetrating trauma in 6 %, and animal bites in 4 %. Of these, 1,974 (69 %) were discharged home, 517 (18 %) taken to the operating room, and 14 (1 %) to the intensive care unit. The body areas most severely injured were pelvis and extremity in 43 %, head in 30 %, chest in 4 %, and abdomen in 3 %. The estimated injury severity score (eISS) was < 9 in 60 %, 9-24 in 35 %, and > 25 in 2 %. Mortality was 0.7 %. In the multivariate analysis, independent predictors of mortality were eISS a parts per thousand yen9 and Glasgow Coma Score a parts per thousand currency sign12. Road traffic injury was an independent predictor for the need to have surgery. Trauma registry results were presented to the Ministry of Health in Cameroon, prompting the formation of a National Injury Committee.Injuries comprise a significant proportion of ED visits and utilization of surgical services in Yaound,. A prospective approach allows for more extensive information. Thorough data from a prospective trauma registry can be used successfully to advocate for policy towards prevention and treatment of injuries.