scholarly journals Utility of an orthopaedic trauma registry in Ghana

2021 ◽  
Vol 55 (3) ◽  
pp. 213-220
Author(s):  
Elissa K. Butler ◽  
Dominic Konadu-Yeboah ◽  
Peter Konadu ◽  
Dominic Awariyah ◽  
Charles N. Mock
Keyword(s):  
Quality Improvement ◽  
Data Quality ◽  
Trauma Registry ◽  
Motor Vehicle ◽  
Categorical Variables ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Middle Income ◽  
Trauma Registries ◽  
Vehicle Collision

In most low- and middle-income countries, trauma registries are uncommon. Although institutional registries for all trauma patients are ideal, it can be more practical to institute departmental registries for specific subsets of patients. Komfo Anokye Teaching Hospital (KATH) has started a locally developed, self-funded orthopaedic trauma registry. We describe methods and experiences for data collection and examine patient and injury characteristics, data quality, and the utility of the registry. Of 961 individuals in the registry, 67.9% were males, and the median age was 40 years. Motor vehicle collision (23.3%) was the most frequent mechanism of injury. Lower extremity fractures were the most common injury (60.6%), and 43.9% of injuries were managed operatively. Data quality was reasonable with missingness under 10% for 13 of 14 key variables, with inconsistencies of dates of injury, admission, treatment, and discharge in 9.1% of cases. However, the type of operation was missing for 73.2% of operative cases. Despite these limitations, the registry has been used for quality improvement and to successfully advocate for resources to improve trauma care. The registry has been improved by adding more detailed outcome variables, creating a standardisedcodebook of categorical variables, and adding more fields to allow for multiple injuries. In conclusion, it is practical and sustainable to institute a locally developed, self-funded orthopaedic trauma registry in Ghana that provides data with reasonable quality. Such a registry can be used to advocate for more resources to care for injured patients adequately and for quality improvement.

Improved documentation following the implementation of a trauma registry: a means of sustainability for trauma registries in low- and middle-income countries

Injury ◽  
2021 ◽  
Author(s):  
Chantalle L Grant ◽  
Christine Tumuhimbise ◽  
Consolet Ninsiima ◽  
Tessa Robinson ◽  
Dean Eurich ◽  
...  
Keyword(s):  
Trauma Registry ◽  
Middle Income ◽  
Middle Income Countries ◽  
Trauma Registries ◽  
Low And Middle Income

scholarly journals Traumatic Brain Injury Caused by Motor Vehicle Collision and Alcoholism in Piauí

2016 ◽  
Vol 37 (03) ◽  
pp. 174-181
Author(s):  
Benjamim Vale ◽  
Juçara Castro ◽  
Marx Araújo ◽  
Herb Morais ◽  
Lívio Macêdo
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Motor Vehicle ◽  
Care Service ◽  
Diffuse Axonal Injury ◽  
Total Sample ◽  
Motor Vehicle Collision ◽  
Alcoholic Beverages ◽  
Trauma Patients ◽  
Vehicle Collision

Objectives To determine the relationship between alcohol consumption and the incidence of traumatic brain injury (TBI) with diffuse axonal injury (DAI), determining these indices, checking acquired comorbidities and characterizing the patients by gender, age and race/color, as well as describing the characteristics of the motor vehicle collision (vehicle, period of the day, day of the week and site) in people admitted to an emergency hospital in the city of Teresina, in the state of Piauí, Brazil. Methods We have analyzed the data contained in the medical records of patients admitted with a history of motor vehicle collision and severe TBI in intensive care units, based on the forms provided by the Mobile Emergency Care Service (SAMU, in the Portuguese acronym) in the period between February 28 and November 28, 2013. Results In the period covered by the present study, 200 individuals were analyzed, and 54 (27%) had consumed alcohol; of these 11 had DAI. Of the total sample, 17% (34) presented DAI, however, with unknown data regarding the consumption of alcoholic beverages. Conclusion Considering the data, we observed that the profile of the head trauma patients are brown men, mostly (53.5%) aged between 15 and 30 years. The collisions occurred mostly on weekends and at night (55%), and 89.5% of the crashes involved motorcycles.

scholarly journals Post-trauma transmesocolic hernia: a case report

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Doaa Hussin Salam ◽  
Mohannad Al-Tarakji ◽  
Abubaker Ibrahim Alaieb ◽  
Rajvir Singh ◽  
Ayman El-Menyar ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Motor Vehicle ◽  
Epigastric Pain ◽  
Abdominal Distension ◽  
Emergency Laparotomy ◽  
Trauma Patients ◽  
Male Victim ◽  
Internal Hernias ◽  
Vehicle Collision ◽  
Clinical Consequences

Abstract The prevalence of transmesocolic hernias, a subtype of internal hernias (IHs), is generally low. Its clinical consequences, including strangulation, ischemia and even death, however, necessitate awareness. IHs are classified as congenital or acquired as resulting from surgery, trauma or intraperitoneal inflammation. This is a case of a 37-year-old male victim of a motor vehicle collision 1 month prior to the index admission. The trauma-related injuries were managed conservatively and then discharged home. The patient was re-admitted with a 2-day history of epigastric pain, vomiting and abdominal distension. A diagnosis of small bowel obstruction due to a transmesocolic hernia was made on CT and emergency laparotomy performed. The post-operative course was unremarkable. It is vital to consider transmesocolic hernias in trauma patients presenting with a picture of bowel obstruction even in the absence of prior surgery.

scholarly journals Did Amendments to the Ontario Highway Traffic Act in 2009-2010 Affect the Proportion of Alcohol-Related Motor Vehicle Collisions Seen at a Level I Trauma Centre over a 10-year Period?

CJEM ◽  
2016 ◽  
Vol 19 (2) ◽  
pp. 106-111
Author(s):  
Meghan Garnett ◽  
Tanya Charyk Stewart ◽  
Michael R Miller ◽  
Rodrick Lim ◽  
Kristine Van Aarsen ◽  
...  
Keyword(s):  
Injury Severity ◽  
Trauma Registry ◽  
Motor Vehicle ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Highway Traffic ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Level I ◽  
Legislative Amendments

AbstractObjectivesTo determine if changes to the Ontario Highway Traffic Act (OHTA) in 2009 and 2010 had an effect on the proportion of alcohol-related motor vehicle collisions (MVCs) presenting to a trauma centre over a 10-year period.MethodsA retrospective review of the trauma registry at a Level I trauma centre in southwestern Ontario was undertaken. The trauma registry is a database of all trauma patients with an injury severity score (ISS) ≥12 and/or who had trauma team activation. Descriptive statistics were calculated. Interrupted time series analyses with ARIMA modeling were performed on quarterly data from 2004-2013.ResultsA total of 377 drivers with a detectable serum ethanol concentration (SEC) were treated at our trauma centre over the 10-year period, representing 21% of all MVCs. The majority (330; 88%) were male. The median age was 31 years, median SEC was 35.3 mmol/L, and median ISS was 21. A total of 29 (7.7%) drinking drivers died from their injuries after arriving to hospital. There was no change in the proportion of drinking drivers after the 2009 amendment, but there was a significant decline in the average SEC of drinking drivers after changes to the law. There was no difference in the proportion of drinking drivers ≤21 years after introduction of the 2010 amendment for young and novice drivers.ConclusionsThere was a significance decline in the average SEC of all drinking drivers after the 2009 OHTA amendment, suggesting that legislative amendments may have an impact on drinking before driving behaviour.

scholarly journals Epidemiology of pediatric trauma in the Kingdom of Bahrain: a national pediatric trauma registry pilot study

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Jay C. Liu ◽  
Aieshah A. Ismael ◽  
Ayesha Zaidi ◽  
Ban W. Sha’ban ◽  
Shaikha Ebrahim Almutawa ◽  
...  
Keyword(s):  
Public Health ◽  
Policy Implementation ◽  
Trauma Registry ◽  
Motor Vehicle ◽  
Seat Belt ◽  
National Level ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Court System ◽  
Awareness Campaigns

Abstract Background A pediatric trauma registry for the Kingdom of Bahrain would be a novel public health tool for the Bahraini health system. The aim of this study was to explore the epidemiology of pediatric trauma at the national level by describing the distribution of pediatric injury in the Kingdom, and quantifying the burden of injury shouldered by the study population. Methods This multicenter observational cross-sectional study was conducted in Bahrain using data from the Pediatric Trauma Registry (PTR), which was a short-term paper-based prospective trauma registry that collected data over a three-month period in 2018. PTR was based in the pediatric emergency departments (ED) of the three national referral hospitals in the Kingdom. By simultaneously collecting data from all three trauma hospitals in the country, it was assumed that during the data collection period all major pediatric trauma patients in the country would be captured by the study, and that the data collected would provide national estimates of trauma. Inclusion criteria for the study was any individual under the age of 14, that arrived at the ED seeking care for intentional and unintentional injuries. Results A total of 1328 patients were included in the study. Sixty-nine percent of patients were treated and discharged from the ED, 30.5% were admitted to the hospital, admitted for surgery, or seen by a specialist, and 0.5% were declared deceased. The percentage of patients documented as unrestrained during Motor Vehicle Collisions (MVC) was 92.3%, and amongst those involved in MVC, 12% were ejected from the cabin of the vehicle. Conclusions There are significant implications that this study holds for policy implementation and practice surrounding injury prevention in the Kingdom of Bahrain. Low seatbelt utilization and the high proportion of ejection amongst MVC victims warrant immediate public health policy implementation, including enforcement of seat belt laws, strengthening of the traffic court system, and awareness campaigns for MVC prevention. Additionally, pediatric drowning prevention programs centered on constant adult supervision, pool isolation fencing, personal flotation devices, and swimming education should be created to address the mortality attributable to drowning in this study.

Accuracy of injury coding in a trauma registry

Trauma ◽  
2021 ◽  
pp. 146040862110418
Author(s):  
Siobhan Isles ◽  
Paul McBride ◽  
Matt Sawyer ◽  
Alaina Campbell ◽  
Gordon Speed ◽  
...  
Keyword(s):  
Quality Improvement ◽  
New Zealand ◽  
Trauma Registry ◽  
Trauma System ◽  
Abbreviated Injury Scale ◽  
Trauma Registries ◽  
Coding Systems ◽  
Body Regions ◽  
Head Neck ◽  
Selection Of

Introduction Abbreviated Injury Scale has significant advantages over administrative coding systems for trauma analytics as it was developed specifically for injury, provides greater depth of characterisation of injury and has an integrated severity measure. It is used by trauma registries globally as it allows benchmarking between registries and is used to drive quality improvement. However, the consistency of scoring between individuals is not well understood. An audit was undertaken in six tertiary trauma centres in New Zealand to determine variation between AIS coders. Methods Each of six sites was audited by two experienced auditors. A random selection of case was identified in ISS categories 13–24, 25–44 and 45+. The case notes were pulled, and the auditors independently audited the notes,and then compared their results for a consensus result. The consensus result was then compared with the original coders. Results 111 cases were audited. Coding concordance was found in 31% of cases. Of the 69% of cases where discordant coding was observed, the discordance was attributed to incorrect coding (49%), missed injuries (43%) and other reasons (7%). Head and chest body regions were associated with the greatest number, and largest differences in coding scores. The overall mean difference across all cases was an ISS score of 1. Conclusions The overall accuracy of data held in the New Zealand Trauma Registry (NZTR) is suitable for quality improvement and benchmarking purposes, but more work is needed to improve the accuracy of individual cases, particularly those with head/neck and chest injury. Standardised tools to ensure the accuracy of data in a trauma registry is a gap which needs to be addressed to maintain confidence in a contemporary trauma system.

scholarly journals Major trauma patients are not who you might think they are: a linked data study

2019 ◽  
Vol 16 ◽  
Author(s):  
Elizabeth Brown ◽  
Hideo Tohira ◽  
Paul Bailey ◽  
Daniel Fatovich ◽  
Judith Finn
Keyword(s):  
Major Trauma ◽  
Injury Severity ◽  
Motor Vehicle ◽  
High Energy ◽  
Categorical Variables ◽  
Common Mechanism ◽  
Trauma Patients ◽  
Continuous Variables ◽  
Mechanism Of Injury ◽  
Young Males

IntroductionMajor trauma patients are often perceived as being young males injured by high energy transfer mechanisms. The aim of this study was to describe the demographics of major trauma patients who were transported to hospital by ambulance.MethodsThis is a retrospective cohort study of adult major trauma (injury severity score >15) patients transported to hospital by St John Western Australia emergency ambulance in metropolitan Perth, between 1 January 2013 and 31 December 2016. To describe the cohort, median and interquartile range (IQR) were used for continuous variables and counts and percentages for categorical variables. Differences between mechanism of injury groups were assessed using the Kruskal-Wallis test. Trauma deaths were defined as early (declared deceased within 24 hours) or late (declared deceased within 30 days). ResultsA total of 1625 patients were included. The median age was 51 years (IQR 30-75) and 1158 (71%) were male. Falls from standing were the most common mechanism of injury (n=460, 28%) followed by motor vehicle crashes (n=259, 16%). Falls from standing were responsible for the majority of early (n=45/175, 26%) and late deaths (n=69/158, 44%). A large number of early deaths also resulted from motorbike crashes (n=32/175, 18%) with a median age of 34 years (IQR 21-46, p<0.001). ConclusionMajor trauma is not only a disease of the young. More than half of the cohort was more than 51 years of age and the most common cause was a fall from standing. Pre-hospital care must evolve to address the needs of a changing trauma patient demographic.

scholarly journals Epidemiology of injured patients in rural Uganda: A prospective trauma registry’s first 1000 days

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245779
Author(s):  
Dennis J. Zheng ◽  
Patrick J. Sur ◽  
Mary Goretty Ariokot ◽  
Catherine Juillard ◽  
Mary Margaret Ajiko ◽  
...  
Keyword(s):  
Policy Development ◽  
Trauma Registry ◽  
Road Traffic ◽  
Clinical Information ◽  
Trauma Patients ◽  
Multivariate Statistical ◽  
Trauma Registries ◽  
Study Implementation ◽  
Injured Patients ◽  
Peasant Farmers

Trauma is a leading cause of morbidity and mortality worldwide. Data characterizing the burden of injury in rural Uganda is limited. Hospital-based trauma registries are a critical tool in illustrating injury patterns and clinical outcomes. This study aims to characterize the traumatic injuries presenting to Soroti Regional Referral Hospital (SRRH) in order to identify opportunities for quality improvement and policy development. From October 2016 to July 2019, we prospectively captured data on injured patients using a locally designed, context-relevant trauma registry instrument. Information regarding patient demographics, injury characteristics, clinical information, and treatment outcomes were recorded. Descriptive, bivariate, and multivariate statistical analyses were conducted. A total of 4109 injured patients were treated during the study period. Median age was 26 years and 63% were male. Students (33%) and peasant farmers (31%) were the most affected occupations. Falls (36%) and road traffic injuries (RTIs, 35%) were the leading causes of injury. Nearly two-thirds of RTIs were motorcycle-related and only 16% involved a pedestrian. Over half (53%) of all patients had a fracture or a sprain. Suffering a burn or a head injury were significant predictors of mortality. The number of trauma patients enrolled in the study declined by five-fold when comparing the final six months and initial six months of the study. Implementation of a context-appropriate trauma registry in a resource-constrained setting is feasible. In rural Uganda, there is a significant need for injury prevention efforts to protect vulnerable populations such as children and women from trauma on roads and in the home. Orthopedic and neurosurgical care are important targets for the strengthening of health systems. The comprehensive data provided by a trauma registry will continue to inform such efforts and provide a way to monitor their progress moving forward.

Rhabdomyolysis in Obese Trauma Patients

2014 ◽  
Vol 80 (10) ◽  
pp. 1012-1017
Author(s):  
Joshua L. Chan ◽  
Taryne Imai ◽  
Galinos Barmparas ◽  
Jonathan B. Lee ◽  
Alex W. Lamb ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Obese Group ◽  
Surgical Intensive Care Unit ◽  
Trauma Patients ◽  
Surgical Intensive Care ◽  
Traumatic Injuries ◽  
Vehicle Collision ◽  
Level I ◽  
Level Monitoring

Patients sustaining traumatic injuries are at risk for development of rhabdomyolysis. The effect of obesity on this risk is unknown. This study attempted to characterize the role of obesity in the development of rhabdomyolysis after trauma. This was a retrospective review of all trauma patients with creatine kinase (CK) levels admitted to the surgical intensive care unit (SICU) at a Level I trauma center from February 2011 until July 2013. Patients were divided based on their body mass index (BMI): overweight/obese group with BMI 25 kg/m2 or greater and nonoverweight/obese group with BMI less than 25 kg/m2. Primary outcome was CK greater than 10,000 U/L. During the 30-month study period, 198 trauma patients with available CK levels were admitted to the SICU. The majority (27.8%) of patients were involved in a motor vehicle collision. There were 96 patients (48.4%) with BMI 25 kg/m2 or greater and 102 (51.5%) with BMI less than 25 kg/m2. There was no difference in creatinine levels between the two groups (1.5 ± 1.2 mg/dL vs 1.5 ± 1.4 mg/dL, P = 0.83). BMI 25 kg/m2 or greater was independently associated with the development of CK greater than 10,000 U/L (14.6 vs 4.9%; adjusted odds ratio, 3.03; P = 0.04). Patients with BMI 25 kg/m2 or greater are at a significantly higher risk for rhabdomyolysis after trauma. Aggressive CK level monitoring to prevent rhabdomyolysis in this population is strongly encouraged.

scholarly journals Octogenarian Motor Vehicle Collisions: Injury Patterns Matter

2022 ◽  
Vol 15 (1) ◽  
pp. 336-340
Author(s):  
Michael Lemon ◽  
Stephen Helmer ◽  
Kathryn Soba ◽  
Jeanette Ward ◽  
James M Haan
Keyword(s):  
Injury Severity ◽  
Motor Vehicle ◽  
Oldest Old ◽  
Rural Setting ◽  
Common Mechanism ◽  
Trauma Patients ◽  
Injury Patterns ◽  
Discharge Disposition ◽  
Vehicle Collision ◽  
Potential Factors

Introduction.  Motor vehicle collision (MVC) is the second most common mechanism of injury among octogenarians and is on the rise.  These “oldest old” trauma patients have much higher mortality rates than expected.  This study examined potential factors influencing this increased mortality including comorbidities, medications, injury patterns, and hospital interventions. Methods.  A 10-year retrospective review was conducted of patients aged 80 and over who were injured in a MVC.  Data collected included patient demographics, comorbidities, medication use prior to injury, collision details, injury severity and patterns, hospitalization details, outcomes, and discharge disposition. Results.  We identified 239 octogenarian patients involved in a MVC.  Overall mortality was 18.8%.  We recognized an increased mortality for specific injury patterns, patients injured in a rural setting, and those who were transfused, intubated, or admitted to the ICU.  We found no correlation between mortality and medications or comorbidities. Conclusions.  The high mortality rate for octogenarian patients involved in a MVC is related to injury severity, type of injury, and in-hospital complications, and not due to comorbidities and prior medications.

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