三级教学医院成人普通外科病房创伤入院患者的特征及转归
The characteristics and outcomes of trauma admissions to an adult general surgery ward in a tertiary teaching hospital.
作者信息
Bedada Alemayehu Ginbo, Tarpley Margaret J, Tarpley John L
机构信息
Department of Surgery, Faculty of Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana.
Department of Medical Education, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
出版信息
Afr J Emerg Med. 2021 Jun;11(2):303-308. doi: 10.1016/j.afjem.2021.04.002. Epub 2021 Apr 23.
BACKGROUND
Traumatic injuries are proportionally higher in low- and middle-income countries (LMICs) than high-income counties. Data on trauma epidemiology and patients' outcomes are limited in LMICs.
METHODS
A retrospective review of medical records was performed for trauma admissions to the Princess Marina Hospital general surgical (GS) wards from August 2017 to July 2018. Data on demographics, mechanisms of injury, body parts injured, Revised Trauma Score, surgical procedures, hospital stay, and outcomes were analysed.
RESULTS
During the study period, 2610 patients were admitted to GS wards, 1307 were emergency admissions. Trauma contributed 22.1% (576) of the total and 44.1% of the emergency admissions. Among the trauma admissions, 79.3% (457) were male. The median(IQR) age in years was 3024-40. The main mechanisms of injury were interpersonal violence (IPV), 53.1% and road traffic crashes (RTCs), 23.1%. More females than males suffered animal bites (5.9% vs. 0.9%), and burns (8.4% vs. 4.2%), while more males than females were affected by IPV (57.8% vs. 35.3%) and self-harm (5.5% vs. 3.4%). Multiple body parts were injured in 6.6%, mainly by RTCs. Interpersonal violence (IPV) and RTCs resulted in significant numbers of head and neck injuries, 57.3% and 22.2% respectively. More females than males had multiple body-parts injury 34.5% vs. 18.5%. Revised Trauma Score (RTS) of ≤11 was recorded in IPV, 38.4% and RTCs, 33.6%. Surgical procedures were performed on 44.4% patients. The most common surgical procedures were laparotomy (27.8%), insertion of chest tube (27.8%), and craniotomy/burr hole(25.1%). Complications were recorded in 10.1% of the patients(58) including 39 deaths, 6.8% of the 576.
CONCLUSION
Trauma contributed significantly to the total GS and emergency admissions. The most common mechanism of injury was IPV with head and neck the most frequently injured body part. Further studies on IPV and trauma admissions involving paediatric and orthopaedic patients are warranted.
背景
与高收入国家相比，低收入和中等收入国家（LMICs）的创伤性损伤比例更高。LMICs中关于创伤流行病学和患者预后的数据有限。
方法
对2017年8月至2018年7月入住公主港医院普通外科（GS）病房的创伤患者病历进行回顾性研究。分析了人口统计学、损伤机制、受伤身体部位、修订创伤评分、手术程序、住院时间和预后等数据。
结果
在研究期间，2610名患者入住GS病房，其中1307名是急诊入院。创伤占总入院人数的22.1%（576例），占急诊入院人数的44.1%。在创伤入院患者中，79.3%（457例）为男性。年龄中位数[（四分位间距）（范围）]为30岁[24 - 40岁]（13 - 97岁）。主要损伤机制是人际暴力（IPV），占53.1%，道路交通碰撞（RTCs），占23.1%。女性遭受动物咬伤（5.9%对0.9%）和烧伤（8.4%对4.2%）的比例高于男性，而男性受人际暴力（57.8%对35.3%）和自残（5.5%对3.4%）影响的比例高于女性。6.6%的患者有多个身体部位受伤，主要是道路交通碰撞所致。人际暴力（IPV）和道路交通碰撞导致大量头部和颈部受伤，分别占57.3%和22.2%。女性有多个身体部位受伤的比例高于男性，分别为34.5%对18.5%。人际暴力（IPV）和道路交通碰撞患者的修订创伤评分（RTS）≤11分的比例分别为38.4%和33.6%。44.4%的患者接受了手术。最常见的手术是剖腹手术（27.8%）、插入胸管（27.8%）和开颅/钻孔（25.1%）。10.1%的患者（58例）出现并发症，包括39例死亡，占576例的6.8%。
结论
创伤在普通外科和急诊入院总数中占很大比例。最常见的损伤机制是人际暴力，头部和颈部是最常受伤的身体部位。有必要对涉及儿科和骨科患者的人际暴力和创伤入院情况进行进一步研究。
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