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Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda
INTRODUCTION: Traumatic injuries disproportionately affect populations in low and middle-income countries (LMIC) where head injuries predominate. The Rwandan Ministry of Health (MOH) has dramatically improved access to emergency services by rebuilding its health infrastructure. The MOH has strengthe...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Department of Emergency Medicine, University of California, Irvine School of Medicine
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597684/ https://www.ncbi.nlm.nih.gov/pubmed/34787565 http://dx.doi.org/10.5811/westjem.2021.4.50961 |
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author | Karim, Naz Mumporeze, Lise Nsengimana, Vizir J.P. Gray, Ashley Kearney, Alexis Aluisio, Adam R. Mutabazi, Zeta Baird, Janette Clancy, Camille M. Lubetkin, Derek Uwitonze, Jean Eric Nyinawankusi, Jeanne D’Arc Nkeshimana, Menelas Byiringiro, Jean Claude Levine, Adam C. |
author_facet | Karim, Naz Mumporeze, Lise Nsengimana, Vizir J.P. Gray, Ashley Kearney, Alexis Aluisio, Adam R. Mutabazi, Zeta Baird, Janette Clancy, Camille M. Lubetkin, Derek Uwitonze, Jean Eric Nyinawankusi, Jeanne D’Arc Nkeshimana, Menelas Byiringiro, Jean Claude Levine, Adam C. |
author_sort | Karim, Naz |
collection | PubMed |
description | INTRODUCTION: Traumatic injuries disproportionately affect populations in low and middle-income countries (LMIC) where head injuries predominate. The Rwandan Ministry of Health (MOH) has dramatically improved access to emergency services by rebuilding its health infrastructure. The MOH has strengthened the nation’s acute emergency response by renovating emergency departments (ED), developing the field of emergency medicine as a specialty, and establishing a prehospital care service: Service d’Aide Medicale Urgente (SAMU). Despite the prevalence of traumatic injury in LMIC and the evolving emergency service in Rwanda, data regarding head trauma epidemiology is lacking. METHODS: We conducted this retrospective cohort study at the University Teaching Hospital of Kigali (UTH-K) and used a linked prehospital database to investigate the demographics, mechanism, and degree of acute medical interventions amongst prehospital patients with head injury. RESULTS: Of the 2,426 patients transported by SAMU during the study period, 1,669 were found to have traumatic injuries. Data from 945 prehospital patients were accrued, with 534 (56.5%) of these patients diagnosed with a head injury. The median age was 30 years, with most patients being male (80.3%). Motor vehicle collisions accounted for almost 78% of all head injuries. One in six head injuries were due to a pedestrian struck by a vehicle. Emergency department interventions included intubations (6.7%), intravenous fluids (2.4%), and oxygen administration (4.9%). Alcohol use was not evaluated or could not be confirmed in 81.3% of head injury cases. The median length of stay (LOS) in the ED was two days (interquartile range: 1,3). A total of 184 patients were admitted, with 13% requiring craniotomies; their median in-hospital care duration was 13 days. CONCLUSION: In this cohort of Rwandan trauma patients, head injury was most prevalent amongst males and pedestrians. Alcohol use was not evaluated in the majority of patients. These traumatic patterns were predominantly due to road traffic injury, suggesting that interventions addressing the prevention of this mechanism, and treatment of head injury, may be beneficial in the Rwandan setting. |
format | Online Article Text |
id | pubmed-8597684 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Department of Emergency Medicine, University of California, Irvine School of Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-85976842021-11-22 Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda Karim, Naz Mumporeze, Lise Nsengimana, Vizir J.P. Gray, Ashley Kearney, Alexis Aluisio, Adam R. Mutabazi, Zeta Baird, Janette Clancy, Camille M. Lubetkin, Derek Uwitonze, Jean Eric Nyinawankusi, Jeanne D’Arc Nkeshimana, Menelas Byiringiro, Jean Claude Levine, Adam C. West J Emerg Med International Medicine INTRODUCTION: Traumatic injuries disproportionately affect populations in low and middle-income countries (LMIC) where head injuries predominate. The Rwandan Ministry of Health (MOH) has dramatically improved access to emergency services by rebuilding its health infrastructure. The MOH has strengthened the nation’s acute emergency response by renovating emergency departments (ED), developing the field of emergency medicine as a specialty, and establishing a prehospital care service: Service d’Aide Medicale Urgente (SAMU). Despite the prevalence of traumatic injury in LMIC and the evolving emergency service in Rwanda, data regarding head trauma epidemiology is lacking. METHODS: We conducted this retrospective cohort study at the University Teaching Hospital of Kigali (UTH-K) and used a linked prehospital database to investigate the demographics, mechanism, and degree of acute medical interventions amongst prehospital patients with head injury. RESULTS: Of the 2,426 patients transported by SAMU during the study period, 1,669 were found to have traumatic injuries. Data from 945 prehospital patients were accrued, with 534 (56.5%) of these patients diagnosed with a head injury. The median age was 30 years, with most patients being male (80.3%). Motor vehicle collisions accounted for almost 78% of all head injuries. One in six head injuries were due to a pedestrian struck by a vehicle. Emergency department interventions included intubations (6.7%), intravenous fluids (2.4%), and oxygen administration (4.9%). Alcohol use was not evaluated or could not be confirmed in 81.3% of head injury cases. The median length of stay (LOS) in the ED was two days (interquartile range: 1,3). A total of 184 patients were admitted, with 13% requiring craniotomies; their median in-hospital care duration was 13 days. CONCLUSION: In this cohort of Rwandan trauma patients, head injury was most prevalent amongst males and pedestrians. Alcohol use was not evaluated in the majority of patients. These traumatic patterns were predominantly due to road traffic injury, suggesting that interventions addressing the prevention of this mechanism, and treatment of head injury, may be beneficial in the Rwandan setting. Department of Emergency Medicine, University of California, Irvine School of Medicine 2021-11 2021-11-05 /pmc/articles/PMC8597684/ /pubmed/34787565 http://dx.doi.org/10.5811/westjem.2021.4.50961 Text en Copyright: © 2021 Karim et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | International Medicine Karim, Naz Mumporeze, Lise Nsengimana, Vizir J.P. Gray, Ashley Kearney, Alexis Aluisio, Adam R. Mutabazi, Zeta Baird, Janette Clancy, Camille M. Lubetkin, Derek Uwitonze, Jean Eric Nyinawankusi, Jeanne D’Arc Nkeshimana, Menelas Byiringiro, Jean Claude Levine, Adam C. Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda |
title | Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda |
title_full | Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda |
title_fullStr | Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda |
title_full_unstemmed | Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda |
title_short | Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda |
title_sort | epidemiology of patients with head injury at a tertiary hospital in rwanda |
topic | International Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597684/ https://www.ncbi.nlm.nih.gov/pubmed/34787565 http://dx.doi.org/10.5811/westjem.2021.4.50961 |
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