Bundu Ibrahim, Lowsby Richard, Vandy Hassan P, Kamara Suleiman P, Jalloh Abdul Malik, Scott Christella O S, Beynon Fenella
Department of Surgery, Connaught Hospital, University of Sierra Leone Teaching Hospital Complex, Freetown, Sierra Leone.
King's Sierra Leone Partnership, King's Centre for Global Health, King's College London and King's Health Partners, UK.
Afr J Emerg Med. 2019;9(Suppl):S9-S13. doi: 10.1016/j.afjem.2018.07.008. Epub 2018 Jul 27.
Trauma accounts for a significant proportion of the global burden of disease, with highest mortality rates seen in Africa. This epidemic is predicted to increase with urbanisation and an aim of the Sustainable Development Goals is to reduce deaths and trauma caused by road accidents. Data available on urban trauma in Sierra Leone is limited.
We conducted a retrospective observational study of trauma and injury related presentations to the emergency centre (EC) of Connaught Hospital, the principal adult tertiary referral centre in Freetown, Sierra Leone between January and March 2016. Patient demographics are described with mechanism of injury. Additional data on length of stay and surgical procedures were recorded for admissions to the trauma ward.
During the 3-month period, a total of 340 patients with injury presented to the EC, accounting for 11.6% of total attendances and 68% of adult surgical admissions. The majority were male (66%) and mean age was 26 years (IQR 15-40). The proportion of trauma presentations were higher in the evening and at weekends and 41% of patients were triaged as emergency or very urgent cases. Road traffic accidents were the most frequent cause of injury (55%) followed by falls (17%) and assaults (14%). Burns were more common in children. Head and lower limbs were the most commonly injured body parts and a minority of patients underwent surgical procedures. Median length of stay for adult patients was 4.5 days (IQR 2-11) and 7 days (IQR 4-14) for children.
Injury accounts for a high burden of disease at Connaught Hospital and consumes a significant proportion of EC and hospital resources. Efforts should be directed towards strengthening the pre-hospital and emergency trauma systems with accurate, formal data collection as well as targeting injury prevention initiatives and improving road safety to reduce morbidity and mortality.
创伤在全球疾病负担中占很大比例，非洲的死亡率最高。预计随着城市化进程，这一流行病将会增加，可持续发展目标的一个目标是减少道路交通事故造成的死亡和创伤。关于塞拉利昂城市创伤的现有数据有限。
我们对2016年1月至3月期间在塞拉利昂弗里敦主要的成人三级转诊中心康诺特医院急诊科就诊的创伤和损伤相关病例进行了回顾性观察研究。描述了患者的人口统计学特征及受伤机制。记录了创伤病房收治患者的住院时间和手术操作等其他数据。
在这3个月期间，共有340名受伤患者到急诊科就诊，占总就诊人数的11.6%，占成人外科住院人数的68%。大多数为男性（66%），平均年龄为26岁（四分位间距15 - 40岁）。创伤就诊比例在晚上和周末较高，41%的患者被分诊为紧急或非常紧急病例。道路交通事故是最常见的受伤原因（55%），其次是跌倒（17%）和袭击（14%）。烧伤在儿童中更常见。头部和下肢是最常受伤的身体部位，少数患者接受了手术。成年患者的中位住院时间为4.5天（四分位间距2 - 11天），儿童为7天（四分位间距4 - 14天）。
在康诺特医院，损伤造成了很高的疾病负担，消耗了急诊科和医院的大量资源。应努力加强院前和急诊创伤系统，进行准确、正式的数据收集，同时针对预防损伤举措并改善道路安全，以降低发病率和死亡率。
