Juillard Catherine J, Stevens Kent A, Monono Martin Ekeke, Mballa Georges Alain Etoundi, Ngamby Marquise Kouo, McGreevy Jolion, Cryer Gill, Hyder Adnan A
International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA,
World J Surg. 2014 Oct;38(10):2534-42. doi: 10.1007/s00268-014-2604-1.
Injury rates in sub-Saharan Africa are among the highest in the world, but prospective, registry-based reports from Cameroon are limited. We aimed to create a prospective trauma registry to expand the data elements collected on injury at a busy tertiary center in Yaoundé Cameroon.
Details of the injury context, presentation, care, cost, and disposition from the emergency department (ED) were gathered over a 6-month period, by trained research assistants using a structured questionnaire. Bivariate and multivariate models were built to explore variable relationships and outcomes.
There were 2,855 injured patients in 6 months, comprising almost half of all ED visits. Mean age was 30 years; 73 % were male. Injury mechanism was road traffic injury in 59 %, fall in 7 %, penetrating trauma in 6 %, and animal bites in 4 %. Of these, 1,974 (69 %) were discharged home, 517 (18 %) taken to the operating room, and 14 (1 %) to the intensive care unit. The body areas most severely injured were pelvis and extremity in 43 %, head in 30 %, chest in 4 %, and abdomen in 3 %. The estimated injury severity score (eISS) was <9 in 60 %, 9-24 in 35 %, and >25 in 2 %. Mortality was 0.7 %. In the multivariate analysis, independent predictors of mortality were eISS ≥9 and Glasgow Coma Score ≤12. Road traffic injury was an independent predictor for the need to have surgery. Trauma registry results were presented to the Ministry of Health in Cameroon, prompting the formation of a National Injury Committee.
Injuries comprise a significant proportion of ED visits and utilization of surgical services in Yaoundé. A prospective approach allows for more extensive information. Thorough data from a prospective trauma registry can be used successfully to advocate for policy towards prevention and treatment of injuries.
撒哈拉以南非洲的受伤率位居世界前列，但喀麦隆基于登记处的前瞻性报告有限。我们旨在创建一个前瞻性创伤登记处，以扩充在喀麦隆雅温得一家繁忙的三级医疗中心收集到的损伤数据元素。
在6个月期间，由经过培训的研究助理使用结构化问卷收集急诊科的损伤背景、表现、治疗、费用及处置的详细信息。构建双变量和多变量模型以探索变量关系及结果。
6个月内有2855名受伤患者，几乎占急诊科就诊人数的一半。平均年龄为30岁；73%为男性。损伤机制中，道路交通伤占59%，跌倒占7%，穿透伤占6%，动物咬伤占4%。其中，1974人（69%）出院回家，517人（18%）被送往手术室，14人（1%）被送往重症监护病房。受伤最严重的身体部位，骨盆和四肢占43%，头部占30%，胸部占4%，腹部占3%。估计损伤严重程度评分（eISS）<9分的占60%，9 - 24分的占35%，>25分的占2%。死亡率为0.7%。多变量分析中，死亡率的独立预测因素为eISS≥9分和格拉斯哥昏迷评分≤12分。道路交通伤是需要进行手术的独立预测因素。创伤登记处的结果已提交给喀麦隆卫生部，促使成立了国家损伤委员会。
在雅温得，损伤占急诊科就诊人数及外科服务利用的很大比例。前瞻性方法能获取更广泛的信息。来自前瞻性创伤登记处的详尽数据可成功用于倡导制定损伤预防和治疗政策。
