Bake Jacques Fadhili, Mukama Phalek Kambere, Jean-Pierre Mumbere Kigayi, Medard Kabuyaya Kakule, Eugene Munyantwari Akomu
University of Goma, Surgery department, Goma, Democratic Republic of the Congo.
HEAL AFRICA Hospital, Surgery department, Goma, Democratic Republic of the Congo.
BMC Surg. 2025 Aug 1;25(1):333. doi: 10.1186/s12893-025-03090-6.
Trauma represents a significant global health challenge, accounting for an estimated 4.4 million fatalities each year, predominantly affecting low- and middle-income countries (LMICs), especially those experiencing conflict. This research investigates the trends, treatment approaches, and outcomes of trauma patients within a mixed intensive care unit (ICU) at HEAL Africa Hospital located in North Kivu, Democratic Republic of Congo (DRC).
A retrospective cohort study was undertaken to evaluate data from 368 surgical patients who were admitted to the ICU of HEAL Africa Hospital from January 2021 to June 2023. The study gathered information regarding patient demographics, mechanisms of injury, diagnoses, management strategies, types of surgeries performed, utilization of mechanical ventilation, duration of hospital stay, and mortality rates. Data analysis was conducted using SPSS version 26, with categorical data expressed as frequencies. Statistical significance was evaluated using the chi-square test. Factors with a p-value of less than 0.25 in the bivariate analysis were then included in a multivariable logistic regression model.
Among the 368 surgical patients, 167 (45.3%) were trauma cases, predominantly male (sex ratio 4.4:1) with a median age of 32 years. From these 167 cases, motor vehicle collision (MVC) (63.5%) and gunshot wounds (21.6%) were the leading causes of injury. Traumatic brain injury was the most common diagnosis (39.5%), and only 39.5% of patients underwent surgery. Mechanical ventilation was used in 30% of cases. The median length of stay was 2 days, and the overall mortality rate was 28.7%. Patients with extremity trauma were less likely to die while higher mortality rates were observed among mechanically ventilated patients (p < 0.001) and non-operated patients (p = 0.006).
This research underscores the considerable impact of trauma in areas affected by conflict and stresses the critical necessity for the enhancement of trauma care systems and the implementation of targeted interventions aimed at improving surgical outcomes in resource-limited environments.
Not applicable.
创伤是一项重大的全球健康挑战，估计每年造成440万人死亡，主要影响低收入和中等收入国家（LMICs），特别是那些经历冲突的国家。本研究调查了刚果民主共和国（DRC）北基伍省HEAL非洲医院混合重症监护病房（ICU）内创伤患者的趋势、治疗方法和结果。
进行了一项回顾性队列研究，以评估2021年1月至2023年6月期间入住HEAL非洲医院ICU的368例外科患者的数据。该研究收集了有关患者人口统计学、损伤机制、诊断、管理策略、所进行的手术类型、机械通气的使用、住院时间和死亡率的信息。使用SPSS 26版进行数据分析，分类数据以频率表示。使用卡方检验评估统计学意义。在双变量分析中p值小于0.25的因素随后被纳入多变量逻辑回归模型。
在368例外科患者中，167例（45.3%）为创伤病例，主要为男性（性别比4.4:1），中位年龄为32岁。在这167例病例中，机动车碰撞（MVC）（63.5%）和枪伤（21.6%）是主要的损伤原因。创伤性脑损伤是最常见的诊断（39.5%），只有39.5%的患者接受了手术。30%的病例使用了机械通气。中位住院时间为2天，总死亡率为28.7%。四肢创伤患者死亡的可能性较小，而机械通气患者（p<0.001）和未手术患者（p=0.006）的死亡率较高。
本研究强调了创伤在受冲突影响地区的重大影响，并强调了加强创伤护理系统以及实施旨在改善资源有限环境中手术结果的针对性干预措施的迫切必要性。
不适用。
