Mukhopadhyay Baijayanta, Boniface Respicious, Razek Tarek
Mcgill J Med. 2009 Nov 16;12(2):27.
The prevalence of surgical trauma as a global public health hazard has been severely neglected. Trauma surgeons in Uganda and Canada have developed the Kampala Trauma Score (KTS), a trauma severity index specific to east African contexts. Hospitals in Tanzania have begun to use this tool to measure their own trauma management protocols in order to measure the validity of this index regionally. This study sought to enhance analysis of data collected through the KTS, by highlighting the efficacy and the lacunae of this registry through evaluation of the data quality of one ongoing round of data collection at an orthopaedic emergency room in Dar es Salaam, Tanzania. The data was screened for missing values that would have impact on prediction of clinical evolution and also analysed for contradictory evidence. Interviews were conducted with data collectors on the main challenges involved in data gathering and analysis for this project. Analysis of the initial round of data collection confirms road accidents cause the most trauma in Dar es Salaam, with pedestrians being particularly vulnerable. However, critical sources of information such as serious injury scores and two-week followup were inconsistently recorded, thereby limiting outcome measurement. The lack of research resources, both financial and human, had a major impact on the ability to sustain the data collection. While the results of this study demonstrate the public health value of having a mechanism to record trauma, research capacity must be supported in low-resource settings in order to enhance clinical care to accident and injury patients.
作为一种全球公共卫生危害，手术创伤的普遍性一直被严重忽视。乌干达和加拿大的创伤外科医生开发了坎帕拉创伤评分（KTS），这是一种专门针对东非情况的创伤严重程度指数。坦桑尼亚的医院已开始使用该工具来衡量其自身的创伤管理方案，以便在区域范围内评估该指数的有效性。本研究旨在通过评估坦桑尼亚达累斯萨拉姆一家骨科急诊室正在进行的一轮数据收集的数据质量，突出该登记处的有效性和缺陷，从而加强对通过KTS收集的数据进行分析。对数据进行筛选，查找可能影响临床进展预测的缺失值，并分析相互矛盾的证据。就该项目数据收集和分析中涉及的主要挑战，与数据收集人员进行了访谈。对第一轮数据收集的分析证实，道路交通事故在达累斯萨拉姆造成的创伤最为严重，行人尤其易受伤害。然而，诸如重伤评分和两周随访等关键信息来源记录不一致，从而限制了结果测量。缺乏资金和人力等研究资源对维持数据收集的能力产生了重大影响。虽然本研究结果表明建立创伤记录机制具有公共卫生价值，但必须在资源匮乏地区支持研究能力，以加强对事故和受伤患者的临床护理。
