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European Journal of Trauma and Emergency Surgery

Published in:

01-10-2019 | Original Article

Informing prehospital care planning using pilot trauma registry data in Yaoundé, Cameroon

Authors: Obieze Chiemeka Nwanna-Nzewunwa, Marquise Kouo Ngamby, Elinor Shetter, Georges Alain Etoundi Mballa, Isabelle Feldhaus, Martin Ekeke Monono, Adnan A. Hyder, Rochelle Dicker, Kent A. Stevens, Catherine Juillard

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2019

Abstract

Introduction

About 54% of deaths in low- and middle-income countries (LMICs) are attributable to lack of prehospital care. The single largest contributor to the disability-adjusted life years due to poor prehospital care is injury. Despite having disproportionately high injury burdens, most LMIC trauma systems have little prehospital organization. An understanding of existing prehospital care patterns in LMICs is warranted as a precursor to strengthening prehospital systems.

Methods

In this retrospective pilot study, we collected demographic and injury characteristics, therapeutic itinerary, and transport data of patients that were captured by the trauma registry at the Central Hospital of Yaoundé (CHY) from April 15, 2009 to October 15, 2009. Bivariate and multivariate regression analyses were used to explore relationships between care-seeking behavior, method of transport, and predictor variables.

Results

The mean age was 30.2 years (95% CI [29.7, 30.7]) and 73% were male. Therapeutic itinerary was available for 97.5% of patients (N = 2855). Nearly 18.7% of patients sought care elsewhere before CHY and 82% of such visits were at district hospitals or health clinics. Moderately (OR 1.336, p = 0.009) and severely (OR 1.605, p = 0.007) injured patients were more likely to seek care elsewhere before CHY and were less likely to be discharged home after their emergency ward visit as opposed to being admitted to the hospital for further treatment (OR 0.462, p < 0.001). Commercial vehicles provided most prehospital transport (65%), while police or ambulance transported few injured patients (7%).

Conclusions

Possible areas for prehospital trauma care strengthening include training lay commercial vehicle drivers in trauma care and formalizing triage, referral, and communication protocols for prehospital care to optimize timely transfer and care while minimizing secondary injury to patients.

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Title: Informing prehospital care planning using pilot trauma registry data in Yaoundé, Cameroon
Authors: Obieze Chiemeka Nwanna-Nzewunwa
Marquise Kouo Ngamby
Elinor Shetter
Georges Alain Etoundi Mballa
Isabelle Feldhaus
Martin Ekeke Monono
Adnan A. Hyder
Rochelle Dicker
Kent A. Stevens
Catherine Juillard
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2019
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-018-0939-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Informing prehospital care planning using pilot trauma registry data in Yaoundé, Cameroon

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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