Mulugeta Wondwossen, Tilahun Ambaye Dejen, Mershsa Lielt, Bekele Zenebe
University of Gondar.
Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar.
Ann Med Surg (Lond). 2024 May 20;86(7):3893-3899. doi: 10.1097/MS9.0000000000002184. eCollection 2024 Jul.
Injury has become a life-threatening community health problem related to vital morbidity and mortality worldwide. Approximately 90% of injury-related deaths occurred in low-income and middle-income countries. There are limited data that address the outcomes of injuries in adult trauma patients at the time of discharge to improve the outcome of trauma care in developing countries, including Ethiopia. Therefore, this study aimed to determine the mortality following injury and its associated factors among adult patients in comprehensive specialized hospitals in Amhara's national regional state.
An institution-based cross-sectional study was conducted among 596 adult trauma patients admitted between 1 January 2018 and 30 December 2020. A systematic random sampling technique was employed to select the study participants. Data were collected from patient charts and registry books by using a data extraction tool. Data were entered into Epi-data version 4.6, and analysis was done using Stata version 16. The binary logistic regression model was fitted, and both bi-variable and multi-variable logistic regression analyses were employed.
A total of 581 adult trauma patient charts with a recorded rate of 97.5% were included in the final analysis. The overall mortality outcome of injury at discharge was found to be 8.3% (95% CI: 6-10.5%). Age 26-40 years [adjusted odds ratio (AOR): 3.35 (95% CI: 1.35-8.33)], revised trauma score 10 [AOR: 3.11, (95% CI: 1.39-6.99)], duration of time before arrival in hospital more than 24 h [AOR: 3.61 (95% CI: 1.18-11.02)], and surgical management in hospital [AOR: 0.25 (95% CI: 0.12-0.54)] were predictors of mortality in patients with injuries.
In this study, the mortality outcome of injury is considerably high, and the middle age group, late presentation to the hospital, lower revised trauma score, and surgical management were significantly associated with the mortality outcome of injury on discharge from the hospital. Therefore, it is better if clinicians emphasize traumatically injured patients, especially for middle age groups, and lower revised trauma scores.
伤害已成为一个危及生命的社区健康问题，在全球范围内与严重的发病率和死亡率相关。约90%与伤害相关的死亡发生在低收入和中等收入国家。在包括埃塞俄比亚在内的发展中国家，关于成年创伤患者出院时伤害结局的数据有限，难以改善创伤护理的结果。因此，本研究旨在确定阿姆哈拉民族地区州综合专科医院成年患者受伤后的死亡率及其相关因素。
对2018年1月1日至2020年12月31日期间收治的596例成年创伤患者进行了一项基于机构的横断面研究。采用系统随机抽样技术选择研究参与者。通过使用数据提取工具从患者病历和登记簿中收集数据。数据录入Epi - data 4.6版本，并使用Stata 16版本进行分析。拟合二元逻辑回归模型，并采用双变量和多变量逻辑回归分析。
最终分析纳入了581份成年创伤患者病历，记录率为97.5%。出院时伤害的总体死亡率为8.3%（95%置信区间：6 - 10.5%）。年龄26 - 40岁[调整优势比（AOR）：3.35（95%置信区间：1.35 - 8.33）]、修订创伤评分10[AOR：3.11，（95%置信区间：1.39 - 6.99）]、到达医院前时间超过24小时[AOR：3.61（95%置信区间：1.18 - 11.02）]以及在医院接受手术治疗[AOR：0.25（95%置信区间：0.12 - 0.54）]是受伤患者死亡率的预测因素。
在本研究中，伤害的死亡率相当高，中年组、就医延迟、较低的修订创伤评分以及手术治疗与出院时伤害的死亡率结局显著相关。因此，临床医生最好关注创伤患者，尤其是中年组和修订创伤评分较低的患者。
