Ndung'u Anthony, Sun Jared, Musau Joan, Ndirangu Eunice
The Aga Khan University Hospital, Nairobi, 3rd Parklands Avenue, Limuru Road, P.O BOX, Nairobi 30270-00100, Kenya.
Harbor-UCLA Department of Emergency Medicine, 1000 W. Carson St., Building D-9 (Box 21), Torrance, CA 90509, United States.
Afr J Emerg Med. 2019;9(Suppl):S47-S51. doi: 10.1016/j.afjem.2018.12.004. Epub 2019 Feb 5.
Trauma continues to be a major cause of morbidity and mortality especially in the paediatric population of low- and middle-income countries such as Kenya. The aim of this study was to establish the profile and outcomes of admitted paediatric trauma cases at the Aga Khan University Hospital, Nairobi.
This retrospective, descriptive study involved a 12-month chart review (January 2016-December 2016). A total of 218 records were identified of which 144 were reviewed.
Most injuries were amongst boys (65.3%) and the very young (mean age 6), occurred in private residences (42.4% homes, 25.7% residential institutions), were typically caused by falls (56.3%) or penetrating trauma (13.2%), mostly resulted in extremity fractures (45.8% closed, 4.9% open) and burn or head injuries (in infants and small children), and got very little or no pre-hospital care (51.4% no care). Additionally, children with burns, brain injuries, or poly-trauma had the longest hospital stays and highest rates of mortality. A more detailed description of the patterns and outcomes seen are included in the study.
Paediatric injuries remain a major public health problem and contribute a substantial proportion of all paediatric surgical admissions at the Aga Khan University Hospital in Nairobi. Based on the patterns and outcomes seen in this study, we therefore recommend for Nairobi (and possibly Kenya) to establish greater supervision and safety measures for children; targeting safety interventions at all children but particularly at boys, the very young, at home and in residential buildings; building pre-hospital emergency care that can accommodate children; and equipping paediatric trauma hospitals to especially handle bony fractures, burns, head injuries, and poly-traumas. A bespoke trauma registry would benefit the hospital, and likely the country as a whole.
创伤仍然是发病和死亡的主要原因，尤其是在肯尼亚等低收入和中等收入国家的儿童群体中。本研究的目的是确定内罗毕阿迦汗大学医院收治的儿科创伤病例的概况和治疗结果。
这项回顾性描述性研究涉及对12个月的病历进行审查（2016年1月至2016年12月）。共识别出218份记录，其中144份进行了审查。
大多数受伤儿童为男孩（65.3%）且年龄很小（平均年龄6岁），受伤地点多为私人住宅（42.4%为家中，25.7%为寄宿机构），通常由跌倒（56.3%）或穿透性创伤（13.2%）导致，主要造成四肢骨折（45.8%为闭合性骨折，4.9%为开放性骨折）以及烧伤或头部受伤（婴儿和幼儿），且很少或没有接受院前护理（51.4%未接受护理）。此外，烧伤、脑损伤或多发伤的儿童住院时间最长，死亡率最高。研究中包含了对所观察到的模式和结果的更详细描述。
儿科损伤仍然是一个主要的公共卫生问题，在内罗毕阿迦汗大学医院所有儿科外科住院病例中占相当大的比例。基于本研究中观察到的模式和结果，因此我们建议在内罗毕（可能还有肯尼亚）为儿童建立更严格的监管和安全措施；针对所有儿童，尤其是男孩、幼儿、在家中和寄宿建筑中的儿童进行安全干预；建立能够容纳儿童的院前急救护理；并为儿科创伤医院配备设备，特别是用于处理骨折、烧伤、头部受伤和多发伤。一个定制的创伤登记系统将使医院受益，可能对整个国家也有益。
