Jurnal Internasional Afrika vol. 10 issue 2 2020
African Journal of Emergency Medicine
Patterns of injury at an Ethiopian referral hospital: Using an institutional trauma registry to inform injury prevention and systems strengthening

Jurnal Internasional Afrika vol. 10 issue 2 2020
African Journal of Emergency Medicine
Patterns of injury at an Ethiopian referral hospital: Using an institutional trauma registry to inform injury prevention and systems strengthening

Trauma registry
Epidemiology
Injury prevention
Africa
Ethiopia

Background: Data about injury patterns and clinical outcomes are essential to address the burden of injury in
low- and middle-income countries. Institutional trauma registries (ITRs) are a key tool for collecting epidemiologic
data about injury. This study uses ITR data to describe the demographics and patterns of injury of
trauma patients in Addis Ababa, Ethiopia in order to identify opportunities for injury prevention, systems
strengthening and further research.
Methods: This is an analysis of prospectively collected data from a sustainable ITR at Menelik II Specialized
Hospital, a public teaching hospital with trauma expertise. All patients presenting to the hospital with serious
injuries requiring intervention or admission over a 13 month period were included. Univariable and bivariable
analyses were performed for patient demographics and injury characteristics.
Results: A total of 854 patients with serious injuries were treated during the study period. Median age was
33 years and 74% were male. The most common mechanisms of injury were road traffic injuries (RTI) (37%),
falls (30%) and blunt assault (17%). Over half of RTI victims were pedestrians. Median delay in presentation was
2 h; 17% of patients presented over 6 h after injury. 58% of patients were referred from another hospital or a
clinic, and referrals accounted for 84% of patients arriving by ambulance. Median emergency center length of
stay was 2 h and 62% of patients were discharged from the emergency center.
Conclusion: This study highlights the utility of institutional trauma registries in collecting crucial injury surveillance
data. In Addis Ababa, road safety is an important target for injury prevention. Our findings suggest that
the most severely injured patients may not be making it to the referral centers with the capacity to treat their
injuries, thus efforts to improve prehospital care and triage are needed.
African relevance: Injury is a public health priority in Africa. Institutional trauma registries play a crucial role in
efforts to improve trauma care by describing injury epidemiology to identify targets for injury prevention and
systems strengthening efforts. In our context, pedestrian safety is a key target for injury prevention. Improving
prehospital care and developing referral networks are goals for systems strengthening.

Adam D. Laytin, Nebyou Seyoum, Seyoum Kassa, Catherine J. Juillard, Rochelle A. Dicker

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afem

2 January 2020

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