The Pattern and Outcome of Severe Trauma from a Dedicated Trauma Centre in Nigeria: An Observational Study

Abstract

Background: Trauma is a leading cause of mortality and a major contributor to disability in various parts of the world. The pattern of trauma and outcome of trauma differ in various parts of the world. Despite that the Trauma burden in the country is high and there are limited published studies on the pattern and outcome of severe trauma in Nigeria presently.

Aim: To evaluate the pattern and outcome of severe trauma at dedicated regional trauma centre in Port Harcourt, Nigeria.

Method: Data of patients presenting with severe trauma between January 1, 2007 and December 31, 2007 at the hospital was collated and analysed. Trauma demographics, type of care and the outcome of care of the recruited patients was evaluated and presented as descriptive statistics.

Result: Seven hundred and sixty two patients were seen with severe trauma but data of 746 patients had enough information was analysed. These represents 12.3% of the total number of patients with trauma seen at the hospital (n = 6180). Most of the patients with severe trauma seen at the centre were males with a mean age ± standard deviation, 28.5 ± 11.3 years. Road traffic collision was the commonest cause of injury (41.2%) but gunshot wounds contributed a sizable number of the injuries (36.7%). The median Injury Severity Score (ISS) was 20 (range = 16 – 75) while the mean Revised Trauma Score (RTS) ± SD was 7.1 ± 1.3. Mortality among patients with severe trauma was 90 (12.1%). Three hundred and forty two patients (45.1%) had satisfactory and good outcome whereas 260 patients (34.9%) had fair and poor outcome. Some patient (n=24 {3.2%}) discharged themselves from the hospital against medical advice, Head injury was the highest contributor to mortality

Conclusion: Trauma burden is an identified problem in Port Harcourt Nigeria. Road traffic crashes and gunshot wounds were the highest contributor of severe trauma at the centre. Severe trauma constitutes only 12% of trauma cases seen at the centre and mortality from severe trauma was 12%.

Keywords: Trauma, Severe Trauma, Trauma Pattern, Outcome, Nigeria