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头部损伤——一个被忽视的公共卫生问题:埃塞俄比亚吉马大学专科医院的一项为期四个月的前瞻性研究。

Head injury--a neglected public health problem: a four-month prospective study at Jimma University Specialized Hospital, Ethiopia.

作者信息

Aenderl Isabel, Gashaw Teshager, Siebeck Matthias, Mutschler Wolf

机构信息

Department of Surgery, Ludwig Maximilian University, Munich, Germany.

Department of Surgery, College of Public Health and Medical Science, Jimma University, Ethiopia.

出版信息

Ethiop J Health Sci. 2014 Jan;24(1):27-34. doi: 10.4314/ejhs.v24i1.4.

Abstract

BACKGROUND

Trauma, especially head trauma, is an expanding major public health problem and the leading cause of death of the young and productive part of the world's population. Research is mainly done in high-income countries where only a small proportion of the worldwide fatalities occur. The intention of this study was to analyze head injury in a setting where most patients in low- and middle-income countries receive treatment, a referral hospital with general but no neurosurgical service like Jimma University Specialized Hospital. The study aims to provide surgeons, hospital managers and health planners working in similar set-ups with baseline information for further investigation and prevention programs intending to reduce the burden of head injury.

METHODS

All head injury patients presented to Jimma University Specialized Hospital between March and June 2010 were included in this prospective research. Epidemiological, clinical and management data were collected for the study.

RESULTS

Out of 52 patients, 47 were males. The median age was 20.0 years (SD=13.3). Fights (n=20, 38.5%) and road traffic accidents (n=19, 36.5%) were the most common causes of head injury. Half of the patients sustained mild and 36.5% sustained severe head injury. The initial GCS had a significant correlation with the outcome. The mortality rate was 21.2%. Of all patients 76.9% were managed conservatively.

CONCLUSION

Prevention of road traffic accidents and improvement of conservative care were identified as major methods to reduce the burden of head injury in a set-up similar to Jimma. Further studies on head injury patients in low-income countries should be done.

摘要

背景

创伤,尤其是头部创伤,是一个日益严重的重大公共卫生问题,也是全球年轻且有生产力人群死亡的主要原因。相关研究主要在高收入国家开展,而这些国家的死亡人数仅占全球死亡总数的一小部分。本研究旨在分析在中低收入国家大多数患者接受治疗的环境下的头部损伤情况,该环境为一家如吉马大学专科医院这样设有普通科室但无神经外科服务的转诊医院。本研究旨在为在类似机构工作的外科医生、医院管理人员和卫生规划人员提供基线信息,以便开展进一步调查和预防项目,从而减轻头部损伤的负担。

方法

纳入2010年3月至6月期间在吉马大学专科医院就诊的所有头部损伤患者进行这项前瞻性研究。收集研究所需的流行病学、临床和管理数据。

结果

52例患者中,47例为男性。中位年龄为20.0岁(标准差=13.3)。斗殴(n=20,38.5%)和道路交通事故(n=19,36.5%)是头部损伤最常见的原因。一半患者为轻度损伤,36.5%为重度头部损伤。初始格拉斯哥昏迷评分(GCS)与预后显著相关。死亡率为21.2%。所有患者中76.9%接受了保守治疗。

结论

预防道路交通事故和改善保守治疗被确定为在类似吉马的环境中减轻头部损伤负担的主要方法。应进一步对低收入国家的头部损伤患者开展研究。

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