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Establishment of trauma registry at Queen Elizabeth Central Hospital(QECH), Blantyre, Malawi and mapping of high risk geographic areas for trauma

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World Journal of Emergency Medicine 2019年第1期10卷 33-41页

作者： Linda C.Chokotho Wakisa Mulwafu mulinda nyirenda Foster J.Mbomuwa Hemant G.Pandit Grace Le Christopher Lavy Beit Cure International Hospital Department of Surgery College of Medicine University of Malawi Adult Emergency and Trauma Center Queen Elizabeth Central Hospital Ministry of Health Chapel Allerton Hospital University of Leeds Nuff ield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences University of Oxford

BACKGROUND: Less attention is directed toward gaining a better understanding of the burden and prevention of injuries, in low and middle income countries(LMICs). We report the establishment of a trauma registry at the Adult Emergency and Trauma Centre(AETC) at Queen Elizabeth Central Hospital(QECH) in Blantyre, Malawi and identify high risk geographic areas. METHODS: We devised a paper based two-page trauma registry form. Ten data clerks and all AETC clinicians were trained to complete demographic and clinical details respectively. Descriptive data, regression and hotspot analyses were done using STATA 15 statistical package and ArcGIS(16) software ***: There were 3,747 patients from May 2013 to May 2015. The most common mechanisms of injury were assault(38.2%), and road traffi c injuries(31.6%). The majority had soft tissue injury(53.1%), while 23.8% had no diagnosis indicated. Fractures(OR 19.94 [15.34–25.93]), head injury and internal organ injury(OR 29.5 [16.29–53.4]), and use of ambulance(OR 1.57 [1.06–2.33]) were found to be predictive of increased odds of being admitted to hospital while assault(OR 0.69 [0.52–0.91]) was found to be associated with less odds of being admitted to hospital. Hot spot analysis showed that at 99% confidence interval, Ndirande, Mbayani and Limbe were the top hot spots for injury occurrence. CONCLUSION: We have described the process of establishing an integrated and potentially sustainable trauma registry. Signifi cant data were captured to provide details on the epidemiology of trauma and insight on how care could be improved at AETC and surrounding health facilities. This approach may be relevant in similar poor resource settings.

关键词： Trauma Registry Adult injuries Hot spot analysis Low and middle income countries

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