ABSTRACT
Introduction: Globally; more worldwide deaths in 2010 could be attributed to injuries than the total number of deaths from infection with AIDS; tuberculosis; and malaria combined; with a disproportionate number of these deaths occurring in low- and middle-income countries. Yet; worldwide research and plans for prevention of injuries are far below other world health problems; especially in developing countries. Methods: A 31-item; 2-page registry form was adapted from regional trauma registries for use in Rwanda to collect data at the two main university referral hospitals in Kigali and Butare. Beginning in 2011; registrars recorded demographics; pre-hospital care; initial physiology; early interventions; and disposition of injured patients who met our selection criteria. Inpatient 30-day discharge status; mortality; and complications were abstracted from patient charts; ward reports and operating room logs. Descriptive analysis was used to evaluate patterns of injury and basic injury epidemiology at the two study hospitals from August 1; 2011-January 31; 2013. Results: A total of 3599 patients were registered from August 1; 2011 to January 31; 2013. Patients were predominantly male; and road traffic crashes were the leading cause of injury overall; contributing to a greater proportion of injuries in the more urban capital than the smaller city of Butare. The majority of patients were admitted to the hospital. All variables evaluated except for the percentage of injuries acquired via a penetrating mechanism showed statistically signifiant differences at an alpha signifiance level of 0.05; illustrating that the trauma population presenting at the two hospitals may be quite different. Conclusion: The Rwanda Injury Registry indicates a high burden of road traffic injuries in a predominantly working age male population over an eighteen-month period. This information can be useful in expanding injury surveillance programs and hopefully implementing population-based prevention programs
Subject(s)
Accidents , Hospitals , Registries , Teaching , Wounds and Injuries/epidemiologyABSTRACT
Background: Road traffic injury is of growing public health importance because of it significant contribution to the global disease burden. The need to predict outcome of injuries has led to the development of injury scores. The Kampala Trauma Score II (KTSII) now recommended for use in resource-poor settings; has not been compared with; the New Injury Severity Score (NISS) preferred by many authors. We compared the performance; predictive power; sensitivity; and specificity in predicting mortality at two weeks of the KTSII and NISS in patients involved in road traffic accidents seen on the surgical ward at Mbarara Regional Referral Hospital (MRRH). Methods: This prospective study conducted between June 2005 and August 2006; examined clinical and radiological data of 173 consecutive patients admitted to the emergency surgical ward at Mbarara Regional Referral Hospital with road traffic injuries. Only patients presenting within 24 hours of injury and with 3 or more injuries were recruited in the study. The KTS II and NISS scores were computed for each patient on admission. The primary outcome measure was survival. Receiver Operating Characteristics (ROC) analysis; and logistic regression analysis were used for comparison. Results: The KTSII predicted mortality and discharge with AUC of 0.87 (NISS; AUC 0.89). The KTSII was less accurate (AUC 0.65) than the NISS (AUC 0.83) in predicting long stay in the hospital. At cut off point of 9 and below; the KTSII had sensitivity of 87and specificity of 81while the NISS had 96and 78.4respectively in predicting mortality. e KTS IIpredicted long hospital stay at cut off score of 9 and below; with sensitivity of 87.5and specificity of 81.conclusions: The KTSII is as reliable a predictive score as is the NISS. This study demonstrated hat the KTS II provides reliable objective criterion upon which injured patients can be triaged in emergency care conditions. The KTS II may enhance the use of ambulance services and timely transfer of the injured and its use in trauma management should be further encouraged in resource-poor settings. In addition; the KTS II will make the documentation of the epidemiology of trauma more feasible in resource-poor settings