Pattern of trauma in elderly patients seen at the trauma centre of national hospital Abuja, Nigeria.

INTRODUCTION: The global population is aging, creating challenges for health systems. The mean age of patients with major trauma has increased over time, posing some challenges for trauma system designs. Elderly trauma patients are said to have higher mortality rates and longer hospital and intensive care unit stays. This study is aimed at assessing the pattern of injuries in elderly population in a dedicated trauma centre of a developing economy. METHODS: This is a retrospective study of all patients aged 60 years and above seen in the trauma centre of a West African tertiary hospital over a three year period from January 2017 to December 2019. Relevant parameters including Sociodemographic data, injury pattern and injury scores were derived from the trauma registry. Data analysis was done using statistical package for social sciences (SPSS) version 24. Results were presented using tables and a figure. RESULTS: A total of 183 patients aged 60 years and above were enrolled out of 4549 general trauma patients, representing 4% of the trauma patient population seen. Male to female ratio was 2.3 with the mean age of 65 ± 6.3. The most frequent mechanisms of injury were motor vehicular crash (MVC) (48.4%), followed by falls (16.5%). More proportion of females (21.8%) were significantly found to suffer falls compared to their males (14.2%) counterparts (p < 0.05). Traumatic brain injury was the commonest diagnosis accounting for 24.3% of cases. The predominant revised trauma scores (RTS) and injury severity scores (ISS) were 12 and 1-15 respectively, with overall mortality of 6.1%. CONCLUSION: The proportion of elderly trauma patients studied in this centre is low. MVC is still the leading mechanism of injury in our elderly trauma population. The mortality rate is however low in this study, in line with the low trauma and severity scores. Preventive measures for MVC should be strongly encouraged to reduce the incidence of elderly trauma patients in this part of the world.

The impact of COVID-19 lockdown on acute trauma patients seen at the National Hospital Trauma Centre Abuja, Nigeria.

INTRODUCTION: trauma is the leading cause of mortality in individuals less than 45 years. The principles of Advanced Trauma Life Support (ATLS) which is used around the world in resuscitation of trauma patients have been considered to be safe. However, the outbreak of corona virus disease 2019 (COVID-19) has affected the processes and characteristics of acute trauma patients seen around the world. This study is intended to determine the impact of COVID-19 lockdown on the acute trauma patients seen in a Nigerian trauma centre. METHODS: this is a cross-sectional observational study of trauma patients seen in the resuscitation room of the National Hospital trauma centre in Abuja, Nigeria, from 24th February,2020 to 3rd May, 2020. The participants were consecutive acute trauma patients who were grouped into two: five weeks preceding total lockdown and five weeks of total lockdown. Statistical analysis was done using the statistical package for social sciences (SPSS) version 24.0 while results were presented in tables and a figure. RESULTS: a total of 229 patients were recruited into the study with age range 1 to 62 years, mean age of 28 ± 13 and male to female ratio of 3.87. The patient volume reduced by 41.31% during the lockdown. Though motor vehicular crash (MVC) was the predominant mechanism of injury in both groups making up 37.65% and 23.88% respectively, penetrating assault was more during the lockdown period (17.91% versus 6.17%). The lockdown was further associated with more delayed presentation (52.24% versus 48.15%), more referrals (53.73% versus 32.72%), less severe injury score (29.6% versus 56.7%) and no death in the resuscitation room (0% versus 1.85%). CONCLUSION: despite the reduction in the volume of trauma presentations by 41.31%, patients got the required care with less mortality. Efforts should be directed at sustaining access to acute trauma care in all circumstances to reduce preventable trauma deaths.

Observed benefits of a major trauma centre in a tertiary hospital in Nigeria.

INTRODUCTION: A Trauma System or its components has been shown to improve trauma services and outcome of seriously injured patients. These organised services are non0existent or the components operate in isolation in most African countries.This study was done to identify the observed advances in trauma care service delivery, brought about by the beginning of operation of a trauma centre in the capital city of a West African country. METHODOLOGY: The operation of the trauma centre was reviewed for progress in terms of organisation of care, in-hospital care, training, and referral system and injury prevention. In addition, the challenges facing the trauma centre were also reviewed and discussed. RESULTS: The trauma centre has brought about better organisation of care and specialist availability, various training in trauma surgery, advances in referral and injury prevention. Funding is an identified threat to the function of the centre. DISCUSSION: The trauma centre provided the drive for specialist training in trauma and changes in the process of care. Funding is a threat to optimal function, as was poor inter-relatedness with other local hospitals, pre-hospital services and rescue providers.