尼日利亚脊髓损伤患者的院前转运

Prehospital transport of spinal cord-injured patients in Nigeria.

作者信息

Ahidjo Kawu A, Olayinka Salami A, Ayokunle Olawepo, Mustapha Alimi F, Sulaiman Gbadegesin A A, Gbolahan Adebule T

机构信息

University of Abuja Teaching Hospital, Federal Capital Territory, Gwagwalada, Nigeria.

出版信息

S Afr J Surg. 2012 Feb 14;50(1):3-5.

PMID:22353312

Abstract

BACKGROUND

Well-organised and efficient prehospital transport is associated with an improved outcome in trauma patients. In Nigeria there is a paucity of information on prehospital transport of spinal cord-injured patients and its relation to mortality.

OBJECTIVE

To determine whether prehospital transportation is a predictor of mortality in spinal cord-injured patients in Nigeria.

DESIGN

Prospective cohort study.

METHODS

Prehospital transport-related conditions, injury-to-arrival intervals and persons who brought spinal cord-injured patients to the casualty departments at the University of Abuja Teaching Hospital, Gwagwalada, and the National Orthopaedic Hospital, Lagos, were noted. Data were analysed using descriptive statistics, the chi-square test and multiple logistic regressions.

MAIN OUTCOME MEASURES

Mortality within 6 weeks of admission. Results. During the review period, 168 patients with spinal cord injury presented to the casualty departments. Most presented 24 hours or more after the injury (67.9%) and were brought to casualty by their relatives (58.3%). Saloon cars were the most common mode of transportation (54.2%), most patients (55.4%) lying on their back during transfer. The majority of the patients (75%) had been taken to at least one other hospital before arriving at our casualty departments. The mortality rate was 16.7%. Multivariate analysis after adjusting for age, gender and means of transportation revealed that age (odds ratio (OR) 63.41, 95% confidence interval (CI) 9.24 - 43.53), a crouched position during transfer (OR 23.52, 95% CI 7.26 - 74.53), presentation after 24 hours (OR 5.48, 95% CI 3.20 - 16.42) and multiple hospital presentations (OR 7.94, 95% CI 1.89 - 33.43) were associated with death within 6 weeks of admission.

CONCLUSION

Well-organised and efficient prehospital transport would reduce mortality in spinal cord-injured patients. Providing information on prehospital transport would also reduce mortality.

摘要

背景

组织良好且高效的院前转运与创伤患者预后改善相关。在尼日利亚，关于脊髓损伤患者的院前转运及其与死亡率的关系，相关信息匮乏。

目的

确定在尼日利亚，院前转运是否为脊髓损伤患者死亡率的预测因素。

设计

前瞻性队列研究。

方法

记录在阿布贾大学教学医院（瓜瓜拉达）和拉各斯国立骨科医院，将脊髓损伤患者送至急诊科的院前转运相关情况、受伤至送达间隔时间以及送患者前来的人员。采用描述性统计、卡方检验和多元逻辑回归分析数据。

主要观察指标

入院后6周内的死亡率。结果。在研究期间，168例脊髓损伤患者被送至急诊科。大多数患者在受伤24小时或更长时间后就诊（67.9%），且由亲属送至急诊科（58.3%）。轿车是最常见的转运方式（54.2%），大多数患者（55.4%）在转运过程中仰卧。大多数患者（75%）在到达我们的急诊科之前至少被送往过一家其他医院。死亡率为16.7%。在对年龄、性别和转运方式进行调整后的多变量分析显示，年龄（比值比（OR）63.41，95%置信区间（CI）9.24 - 43.53）、转运过程中蹲伏体位（OR 23.52，95%CI 7.26 - 74.53）、受伤24小时后就诊（OR 5.48，95%CI 3.20 - 16.42）以及多次在其他医院就诊（OR 7.94，95%CI 1.89 - 33.43）与入院后6周内死亡相关。