Saidi Hassan, Oduor Johannes
Department of Human Anatomy, University of Nairobi, P.O. Box 30187, GPO, 00100, Nairobi, Kenya.
J Forensic Leg Med. 2013 Aug;20(6):570-4. doi: 10.1016/j.jflm.2013.04.016. Epub 2013 Jul 9.
Immediate trauma fatality is not amenable to trauma care and primary prevention is the key. The published profiles of deaths due to trauma differ in different regions. Injury mortality rates are higher in developing countries where injury data capture systems are unreliable for prevention purposes.
To describe the pattern of pre-hospital injury (immediate) deaths at the Nairobi city mortuary and compare these with hospital (late) trauma deaths.
Consecutive trauma autopsies performed over one year (November 2009 to December 2010) at the main mortuary of the Nairobi city council were analyzed for demographic (age, sex, occupation) characteristics, circumstances of the trauma and injury patterns. The patterns of injuries were compared to those of victims who survived and later died at the Kenyatta National Hospital over the same period.
Two hundred and thirty seven trauma autopsies were analyzed. The average age of the victims was 29.8 years (range 1-67 years). Christians (93.7%) and males (89.5%) predominated. The place of injury was the road in 32.9% and home/neighborhood in 57.5% of cases. The main mechanisms of fatal injury were traffic (35.4%), gunshot wounds (25.7%) and assault (19.8%). Burns and suicides accounted for 5.9% and 6.3% of fatalities. Most fatalities were intentional (59.4%) Of vehicular injuries, pedestrians predominated (65.5%). For assault, blunt and penetrating injuries accounted for 68.7% and 31.11% of fatalities. Law enforcement officers were responsible for majority of gunshot deaths. Fatal injuries were sustained in single, two and multiple regions in 56.2%, 25.7% and 14.2% of cases. The body region most involved was the head/neck (40.5%). Twelve children under 15 years died. Compared to in-hospital deaths, pre-hospital deaths were associated with intentional injuries, night-time occurrence and preponderance of gun involvement.
Injury was a significant cause of mortality among adults of working age in this urban African setting. Intentional injuries predominate in causation of immediate but not late deaths. Local prevention programs should incorporate mortuary data to unravel further aspects of trauma and address violence as a key determinant of prehospital mortality.
创伤导致的即刻死亡无法通过创伤救治解决，一级预防是关键。不同地区公布的创伤死亡情况各不相同。在发展中国家，伤害死亡率较高，因为其伤害数据收集系统对于预防而言并不可靠。
描述内罗毕市太平间院前创伤（即刻）死亡模式，并将其与医院（延迟）创伤死亡情况进行比较。
对在内罗毕市议会主要太平间进行的为期一年（2009年11月至2010年12月）的连续创伤尸检进行分析，以了解人口统计学特征（年龄、性别、职业）、创伤情况和损伤模式。将损伤模式与同期在肯雅塔国家医院存活后死亡的受害者的损伤模式进行比较。
分析了237例创伤尸检。受害者的平均年龄为29.8岁（范围1 - 67岁）。基督教徒（93.7%）和男性（89.5%）占多数。32.9%的病例受伤地点为道路，57.5%为家中/邻里。致命伤的主要机制为交通伤（35.4%）、枪伤（25.7%）和袭击（19.8%）。烧伤和自杀分别占死亡人数的5.9%和6.3%。大多数死亡为故意所致（59.4%）。在车辆伤中，行人占多数（65.5%）。对于袭击，钝器伤和穿透伤分别占死亡人数的68.7%和31.11%。执法人员导致了大多数枪伤死亡。56.2%、25.7%和14.2%的病例分别在单一、两个和多个部位受到致命伤。最常受累的身体部位是头部/颈部（40.5%）。12名15岁以下儿童死亡。与院内死亡相比，院前死亡与故意伤害、夜间发生以及枪支使用占比高有关。
在这个非洲城市环境中，伤害是劳动年龄成年人死亡的一个重要原因。故意伤害在即刻死亡而非延迟死亡的原因中占主导地位。当地预防项目应纳入太平间数据，以进一步了解创伤情况，并将暴力作为院前死亡率的关键决定因素加以应对。
