Injury characteristics and their association with clinical complications among emergency care patients in Tanzania.
Injury characteristics and their association with clinical complications among emergency care patients in Tanzania.
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DOI：
10.1016/j.afjem.2022.08.001
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发表时间：
2022-12
期刊：
影响因子：
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中科院分区：
文献类型：
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我们的患者样本来自一家国家转诊医院，为1500万人提供了坦桑尼亚西北部伤害发病率和死亡率模式的见解。本研究描述了撒哈拉以南非洲低收入国家三级转诊医院的成人急性损伤患者的特征、预测因素和结局。虽然KCMC接收了大量的伤害患者，但目前尚不清楚在这家医院就诊的全因伤害患者中预后不良的风险因素。本研究的信息旨在帮助改善坦桑尼亚基利曼哈罗地区受伤患者的护理。我们的研究结果表明，在基利曼哈罗地区受伤的结果不佳可能取决于受伤，临床和社会人口特征。每年有500多万人因受伤而死亡，另有数百万人因非致命性受伤而需要医疗护理。90%的伤害死亡发生在低收入和中等收入国家（LMIC）。本研究描述了撒哈拉以南非洲低收入国家三级转诊医院的成人急性损伤患者的特征、预测因素和结局。该二次分析使用坦桑尼亚莫希的基利曼哈罗基督教医疗中心（KCMC）的成人急性损伤登记。我们从社会人口统计学、临床指标、损伤模式、治疗和出院时的结局方面描述了这一患者样本。结局包括死亡率、住院时间和功能独立性。使用考克斯比例风险模型、负二项回归和多变量逻辑回归来量化患者特征和患者结局之间的关联。在所有损伤患者（n=1365）中，39.0%的患者年龄为30 - 49岁，81.5%为男性。大多数患者至少有小学教育（89.6%）和就业（89.3%）。大多数伤害与道路交通（63.2%）、跌倒（16.8%）或殴打（14.0%）有关。自我报告的合并症包括高血压（5.8%）、HIV（3.1%）和糖尿病（2.3%）。进行的手术分为骨科（32.3%）、普外科（4.1%）、神经科（3.7%）或其他（59.8%）。大多数患者在受伤后至少4小时到达医院（53.9%）。死亡率为5.3%，中位住院时间为6.1天（IQR：3.1，15.0），自理依赖性为54.2%，运动依赖性为41.5%。我们的研究样本主要包括遭受道路交通事故的年轻男性，他们延迟了住院时间和住院时间。年龄较大，男性，需要非整形外科手术或患有艾滋病毒预示着预后更差。需要采取以预防和治疗为重点的干预措施，以降低KCMC的伤害死亡率和发病率，从而降低伤害率并改善伤害结局。
Our patient sample from a national referral hospital serving upwards of 15 million people provides insight into patterns of injury morbidity and mortality in Northwestern Tanzania. This study describes the characteristics, predictors and outcomes of adult acute injury patients presenting to a tertiary referral hospital in a low-income country in sub-Saharan Africa. Although KCMC receives a large number of injury patients, risk factors for poor outcomes among all-cause injury patients who present to this hospital are not clear. Information from this study is intended to aid the improvement of care received by injury patients in the Kilimanjaro region of Tanzania. Our findings demonstrate that poor injury outcomes in the Kilimanjaro region may be dependent on injury, clinical, and sociodemographic characteristics. Over 5 million people annually die from injuries and millions more sustain non-fatal injuries requiring medical care. Ninety percent of injury deaths occur in low- and middle-income countries (LMICs). This study describes the characteristics, predictors and outcomes of adult acute injury patients presenting to a tertiary referral hospital in a low-income country in sub-Saharan Africa. This secondary analysis uses an adult acute injury registry from Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. We describe this patient sample in terms of socio-demographics, clinical indicators, injury patterns, treatments, and outcomes at hospital discharge. Outcomes include mortality, length of hospital stay, and functional independence. Associations between patient characteristics and patient outcomes are quantified using Cox proportional hazards models, negative binomial regression, and multivariable logistic regression. Of all injury patients (n=1365), 39.0% were aged 30 to 49 years and 81.5% were men. Most patients had at least a primary school education (89.6%) and were employed (89.3%). A majority of injuries were road traffic (63.2%), fall (16.8%), or assault (14.0%) related. Self-reported comorbidities included hypertension (5.8%), HIV (3.1%), and diabetes (2.3%). Performed surgeries were classified as orthopedic (32.3%), general (4.1%), neurological (3.7%), or other (59.8%). Most patients reached the hospital at least four hours after injury occurred (53.9%). Mortality was 5.3%, median length of hospital stay was 6.1 days (IQR: 3.1, 15.0), self-care dependence was 54.2%, and locomotion dependence was 41.5%. Our study sample included primarily young men suffering road traffic crashes with delayed hospital presentations and prolonged hospital stays. Being older, male, and requiring non-orthopedic surgeries or having HIV portends a worse prognosis. Prevention and treatment focused interventions to reduce the burden of injury mortality and morbidity at KCMC are needed to lower injury rates and improve injury outcomes.
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DOI：
10.1136/injuryprev-2015-041616
发表时间：
2016-02
期刊：
Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
影响因子：
--
作者：
Haagsma JA;Graetz N;Bolliger I;Naghavi M;Higashi H;Mullany EC;Abera SF;Abraham JP;Adofo K;Alsharif U;Ameh EA;Ammar W;Antonio CA;Barrero LH;Bekele T;Bose D;Brazinova A;Catalá-López F;Dandona L;Dandona R;Dargan PI;De Leo D;Degenhardt L;Derrett S;Dharmaratne SD;Driscoll TR;Duan L;Petrovich Ermakov S;Farzadfar F;Feigin VL;Franklin RC;Gabbe B;Gosselin RA;Hafezi-Nejad N;Hamadeh RR;Hijar M;Hu G;Jayaraman SP;Jiang G;Khader YS;Khan EA;Krishnaswami S;Kulkarni C;Lecky FE;Leung R;Lunevicius R;Lyons RA;Majdan M;Mason-Jones AJ;Matzopoulos R;Meaney PA;Mekonnen W;Miller TR;Mock CN;Norman RE;Orozco R;Polinder S;Pourmalek F;Rahimi-Movaghar V;Refaat A;Rojas-Rueda D;Roy N;Schwebel DC;Shaheen A;Shahraz S;Skirbekk V;Søreide K;Soshnikov S;Stein DJ;Sykes BL;Tabb KM;Temesgen AM;Tenkorang EY;Theadom AM;Tran BX;Vasankari TJ;Vavilala MS;Vlassov VV;Woldeyohannes SM;Yip P;Yonemoto N;Younis MZ;Yu C;Murray CJ;Vos T
通讯作者：
Vos T
DOI：
10.1016/j.injury.2015.01.008
发表时间：
2015-04-01
影响因子：
2.5
作者：
Harmsen, A. M. K.;Giannakopoulos, G. F.;Bloemers, F. W.
通讯作者：
Bloemers, F. W.
影响因子：
3.7
作者：
Diamond, Megan B.;Dalal, Shona;Holmes, Michelle D.
通讯作者：
Holmes, Michelle D.
影响因子：
1.2
作者：
Bellet, Fanuel Damian;Rashid, Sakina Mehboob;Temu, Rogers Joackim
通讯作者：
Temu, Rogers Joackim
影响因子：
2
作者：
Krebs, Elizabeth;Gerardo, Charles J.;Thielman, Nathan M.
通讯作者：
Thielman, Nathan M.