Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8- 29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

The Epidemiological Use of Hospital Data for Suicide Surveillance in Belgium.

Aims: Investigating the E codes related to suicide and self-inflicted injuries through the prevalence, the patient characteristics, the methods and means employed and the characteristics of the hospital stays; and compare them with the others E codes group. Study Design: Retrospective hospital-based analytical study. Place and Duration of Study: This study was based on the 2010 data of 13 Belgian hospitals. Methodology: Based on 16406 cases of patients with a least an E code (ICD-9-CM); Pearson’s chi-squaretests, simple logistic regressions and Wilcoxon rank sum tests were used to assess the variations between distributions of the investigated factors according to the injury’s groups. Results: Among all the E codes, prevalence of suicide and self-inflicted injury was equal to 10.6%. The poisoning was the major reported diagnosis. There were significantly Original Research Article British Journal of Medicine & Medical Research, 4(26): 4407-4430, 2014 4408 more discharges without consent in the suicide group than in the others. The length of stay was lowest in the suicide group compared to the others E codes group. The several median costs were always highest among the men, but, regarding the median percentage of the pharmaceutical products, the value was highest among the women. Conclusion: The epidemiological use of hospital data is complementary to the use of both the population-based data and the death certificates; each data source participating to a better comprehension and a better surveillance of the complex continuum of suicidality.