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Injury characteristics and their association with clinical complications among emergency care patients in Tanzania.
Abstract
<h4>Background</h4>Over 5 million people annually die from injuries and millions more
sustain non-fatal injuries requiring medical care. Ninety percent of injury deaths
occur in low- and middle-income countries (LMICs). This study describes the characteristics,
predictors and outcomes of adult acute injury patients presenting to a tertiary referral
hospital in a low-income country in sub-Saharan Africa.<h4>Methods</h4>This secondary
analysis uses an adult acute injury registry from Kilimanjaro Christian Medical Centre
(KCMC) in Moshi, Tanzania. We describe this patient sample in terms of socio-demographics,
clinical indicators, injury patterns, treatments, and outcomes at hospital discharge.
Outcomes include mortality, length of hospital stay, and functional independence.
Associations between patient characteristics and patient outcomes are quantified using
Cox proportional hazards models, negative binomial regression, and multivariable logistic
regression.<h4>Results</h4>Of all injury patients (n=1365), 39.0% were aged 30 to
49 years and 81.5% were men. Most patients had at least a primary school education
(89.6%) and were employed (89.3%). A majority of injuries were road traffic (63.2%),
fall (16.8%), or assault (14.0%) related. Self-reported comorbidities included hypertension
(5.8%), HIV (3.1%), and diabetes (2.3%). Performed surgeries were classified as orthopedic
(32.3%), general (4.1%), neurological (3.7%), or other (59.8%). Most patients reached
the hospital at least four hours after injury occurred (53.9%). Mortality was 5.3%,
median length of hospital stay was 6.1 days (IQR: 3.1, 15.0), self-care dependence
was 54.2%, and locomotion dependence was 41.5%.<h4>Conclusions</h4>Our study sample
included primarily young men suffering road traffic crashes with delayed hospital
presentations and prolonged hospital stays. Being older, male, and requiring non-orthopedic
surgeries or having HIV portends a worse prognosis. Prevention and treatment focused
interventions to reduce the burden of injury mortality and morbidity at KCMC are needed
to lower injury rates and improve injury outcomes.
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Journal articlePermalink
https://hdl.handle.net/10161/25914Published Version (Please cite this version)
10.1016/j.afjem.2022.08.001Publication Info
Zimmerman, Armand; Barcenas, Loren K; Pesambili, Msafiri; Sakita, Francis; Mallya,
Simon; Vissoci, Joao Ricardo Nickenig; ... Staton, Catherine A (2022). Injury characteristics and their association with clinical complications among emergency
care patients in Tanzania. African journal of emergency medicine : Revue africaine de la medecine d'urgence, 12(4). pp. 378-386. 10.1016/j.afjem.2022.08.001. Retrieved from https://hdl.handle.net/10161/25914.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Janet Prvu Bettger
Adjunct Associate in the Department of Orthopaedic Surgery
Dr. Bettger’s research is dedicated to establishing real world evidence aimed to improve
health care quality and policies that reduce the burden of disease and disability.
As a health services researcher and implementation scientist, her research extends
from observational studies to randomized and pragmatic trials. She was the Founding
Director of Duke Roybal Center for Translational Research in the Behavioral and Social
Sciences of Aging and the Founding Director of Undergraduate
Blandina Mmbaga
Adjunct Associate Professor of Global Health
Lawrence P Park
Associate Professor in Medicine
Catherine Ann Staton
Associate Professor of Emergency Medicine
Catherine Staton MD MSc
Dr. Staton is an Associate Professor in Emergency Medicine (EM), Neurosurgery & Global
Health with tenure at Duke University. She is the Director of the GEMINI (Global EM
Innovation & Implementation) Research Center and the EM Vice Chair of Research Strategy
& Faculty Development. Her research integrates innovative implementation methods into
health systems globally to improve access to acute care. In 2012, with an injury registry
at Kilimanjaro Chr
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