Jurnal Internasional Afrika vol.12 issue 4 2022
African Journal of Emergency Medicine
Injury characteristics and their association with clinical complications among emergency care patients in Tanzania

Jurnal Internasional Afrika vol.12 issue 4 2022
African Journal of Emergency Medicine
Injury characteristics and their association with clinical complications among emergency care patients in Tanzania

Injury Trauma Emergency medicine Emergency care Tanzania LMICs

Background: Over 5 million people annually die from injuries and millions more sustain non-fatal injuries re- quiring medical care. Ninety percent of injury deaths occur in low- and middle-income countries (LMICs). This study describes the characteristics, predictors and outcomes of adult acute injury patients presenting to a tertiary referral hospital in a low-income country in sub-Saharan Africa. Methods: This secondary analysis uses an adult acute injury registry from Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. We describe this patient sample in terms of socio-demographics, clinical indicators, injury patterns, treatments, and outcomes at hospital discharge. Outcomes include mortality, length of hospital stay, and functional independence. Associations between patient characteristics and patient outcomes are quanti- fied using Cox proportional hazards models, negative binomial regression, and multivariable logistic regression. Results: Of all injury patients (n = 1365), 39.0% were aged 30 to 49 years and 81.5% were men. Most patients had at least a primary school education (89.6%) and were employed (89.3%). A majority of injuries were road traffic (63.2%), fall (16.8%), or assault (14.0%) related. Self-reported comorbidities included hypertension (5.8%), HIV (3.1%), and diabetes (2.3%). Performed surgeries were classified as orthopedic (32.3%), general (4.1%), neu- rological (3.7%), or other (59.8%). Most patients reached the hospital at least four hours after injury occurred (53.9%). Mortality was 5.3%, median length of hospital stay was 6.1 days (IQR: 3.1, 15.0), self-care dependence was 54.2%, and locomotion dependence was 41.5%. Conclusions: Our study sample included primarily young men suffering road traffic crashes with delayed hospital presentations and prolonged hospital stays. Being older, male, and requiring non-orthopedic surgeries or having HIV portends a worse prognosis. Prevention and treatment focused interventions to reduce the burden of injury mortality and morbidity at KCMC are needed to lower injury rates and improve injury outcomes.
Introduction
Injury accounts for 9% of global deaths and 11% of all disability- adjusted life years (DALYs) making it a leading cause of death and dis- ability worldwide [ 1 , 2 ]. Every year nearly 5 million people die from injuries and hundreds of millions more sustain non-fatal injuries that require medical care [ 3 , 4 ]. Non-fatal injuries have been associated with additional behavioral and physical health consequences including vio- lence, substance abuse, and cardiovascular disease [5–9] . The greatest burden of injury occurs in low and middle-income coun- tries (LMICs) which collectively account for 90% of all injury deaths
∗ Corresponding author. E-mail address: catherine.lynch@duke.edu (C.A. Staton) .
[1] . Among LMICs, sub-Saharan Africa experiences one

Armand Zimmerman , Loren K. Barcenas , Msafiri Pesambili , Francis Sakita , Simon Mallya , Joao Ricardo Nickenig Vissoci , Lawrence Park, Blandina T. Mmbaga, Janet Prvu Bettger , Catherine A. Staton

www.elsevier.com/locate/afjem

14 August 2022

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