Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Association between volume resuscitation & mortality among injured patients at a tertiary care hospital in Kigali, Rwanda
Dublin Core
Title
Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Association between volume resuscitation & mortality among injured patients at a tertiary care hospital in Kigali, Rwanda
African Journal of Emergency Medicine
Association between volume resuscitation & mortality among injured patients at a tertiary care hospital in Kigali, Rwanda
Subject
Injury care
Resuscitation
Global health
Low- & middle-income countries
Resuscitation
Global health
Low- & middle-income countries
Description
Background: Injuries cause significant morbidity and mortality in sub-Saharan African countries such as Rwanda.
These burdens may be compounded by limited access to intravenous (IV) resuscitation fluids such as crystalloids
and blood products. This study evaluates the association between emergency department (ED) intravenous
volume resuscitation and mortality outcomes in adult trauma patients treated at the University Teaching
Hospital-Kigali (UTH- K).
Methods: Data were abstracted using a structured protocol for a random sample of ED patients treated during
periods from 2012 to 2016. Patients under 15 years of age were excluded. Data collected included demographics,
clinical aspects, types of IV fluid resuscitation provided and outcomes. The primary outcome was facility-based
mortality. Descriptive statistics were used to explore characteristics of the population. Kampala Trauma Scores
(KTS) were used to control for injury severity. Magnitudes of effects were quantified using multivariable
regression models adjusted for gender, KTS, time period, clinical interventions, presence of head injury and
transfer to a tertiary care centre to yield adjusted odds ratios (aOR) with 95% confidence intervals (CI).
Results: From the random sample of 3609 cases, 991 trauma patients were analysed. The median age was 32 [IQR
26, 46] years and 74.3% were male. ED volume resuscitation was given to 50.1% of patients with 43.5%
receiving crystalloid and 6.4% receiving crystalloid and packed red blood cell (PRBC) transfusions. The median
KTS score was 13 [IQR 12, 13]. In multivariable regression, mortality likelihood was increased in those who
received crystalloid (aOR = 4.31, 95%CI 1.24, 15.05, p = 0.022) and PRBC plus crystalloid (aOR = 9.97, 95%CI
2.15,46.17, p = 0.003) as compared to trauma patients not treated with IV resuscitation fluids.
Conclusions: Injured ED patients treated with volume resuscitation had higher mortality, which may be due to
unmeasured confounding or therapies provided. Further studies on fluid resuscitation in trauma populations in
resource-limited settings are needed.
These burdens may be compounded by limited access to intravenous (IV) resuscitation fluids such as crystalloids
and blood products. This study evaluates the association between emergency department (ED) intravenous
volume resuscitation and mortality outcomes in adult trauma patients treated at the University Teaching
Hospital-Kigali (UTH- K).
Methods: Data were abstracted using a structured protocol for a random sample of ED patients treated during
periods from 2012 to 2016. Patients under 15 years of age were excluded. Data collected included demographics,
clinical aspects, types of IV fluid resuscitation provided and outcomes. The primary outcome was facility-based
mortality. Descriptive statistics were used to explore characteristics of the population. Kampala Trauma Scores
(KTS) were used to control for injury severity. Magnitudes of effects were quantified using multivariable
regression models adjusted for gender, KTS, time period, clinical interventions, presence of head injury and
transfer to a tertiary care centre to yield adjusted odds ratios (aOR) with 95% confidence intervals (CI).
Results: From the random sample of 3609 cases, 991 trauma patients were analysed. The median age was 32 [IQR
26, 46] years and 74.3% were male. ED volume resuscitation was given to 50.1% of patients with 43.5%
receiving crystalloid and 6.4% receiving crystalloid and packed red blood cell (PRBC) transfusions. The median
KTS score was 13 [IQR 12, 13]. In multivariable regression, mortality likelihood was increased in those who
received crystalloid (aOR = 4.31, 95%CI 1.24, 15.05, p = 0.022) and PRBC plus crystalloid (aOR = 9.97, 95%CI
2.15,46.17, p = 0.003) as compared to trauma patients not treated with IV resuscitation fluids.
Conclusions: Injured ED patients treated with volume resuscitation had higher mortality, which may be due to
unmeasured confounding or therapies provided. Further studies on fluid resuscitation in trauma populations in
resource-limited settings are needed.
Creator
Catalina Gonz´alez Marqu´es , Katelyn Moretti , Siraj Amanullah , Chantal Uwamahoro , Vincent Ndebwanimana , Stephanie Garbern , Sonya Naganathan , Kyle Martin , Joseph Niyomiza , Annie Gjesvik , Menelas Nkeshimana , Adam C. Levine , Adam R. Aluisio
Source
www.elsevier.com/locate/afjem
Publisher
ELSEVIER
Date
21 September 2020
Contributor
PERI IRAWAN
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Citation
Catalina Gonz´alez Marqu´es , Katelyn Moretti , Siraj Amanullah , Chantal Uwamahoro , Vincent Ndebwanimana , Stephanie Garbern , Sonya Naganathan , Kyle Martin , Joseph Niyomiza , Annie Gjesvik , Menelas Nkeshimana , Adam C. Levine , Adam R. Aluisio , “Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Association between volume resuscitation & mortality among injured patients at a tertiary care hospital in Kigali, Rwanda,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/2594.
African Journal of Emergency Medicine
Association between volume resuscitation & mortality among injured patients at a tertiary care hospital in Kigali, Rwanda,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/2594.