The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approach
| Autor: | Maysel Stella E. Forson-Adae, Bernard Arhin, Ronald F. Maio, Daniel Osei-Kwame, Kwame Ekremet, Hussein A. Yakubu, Rockefeller Oteng |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Original article media_common.quotation_subject lcsh:Medicine Trauma registry Structured panel review Teaching hospital Tertiary care Ghana 03 medical and health sciences 0302 clinical medicine Geochemistry and Petrology Multidisciplinary approach medicine 030212 general & internal medicine Road traffic media_common Cause of death Selection bias lcsh:R5-920 business.industry Mortality rate lcsh:R 030208 emergency & critical care medicine Trauma care Trauma-related death 3. Good health Mechanism of injury Emergency medicine Emergency Medicine lcsh:Medicine (General) business Gerontology Emergency medicine Ghana |
| Zdroj: | African Journal of Emergency Medicine African Journal of Emergency Medicine, Vol 9, Iss 4, Pp 202-206 (2019) |
| ISSN: | 2211-4203 2211-419X |
| Popis: | Introduction The purpose of the study was to determine the preventable trauma-related death rate (PDR) at Komfo Anokye Teaching Hospital in Kumasi, Ghana three years after initiation of an Emergency Medicine (EM) residency Method This was a retrospective, cross-sectional study. A multidisciplinary panel of physicians completed a structured implicit review of clinical data for trauma patients who died during the period 2011 to 2012. The panel judged the preventability of each death and the nature of inappropriate care. Categories were definitely preventable (DP), possibly preventable (PP), and not preventable (NP). Results 1) The total number of cases was forty-five; 36 cases had adequate data for review. Subjects were predominately male; road traffic injury (RTI) was the leading mechanism of injury. Four cases (11.1%) were DP, 14 cases (38.9%) were PP and 18 (50%) were NP. Hemorrhage was the leading cause of death (39%). Among DP/PP deaths there were 37 instances of inappropriate care. Delay in surgical intervention was the predominate event (50%). 2) The PDR for this study was 50% (0.95 CI, 33.7%–66.3%) Conclusion Fifty percent of trauma deaths were DP/PP. Multiple episodes of varying types of inappropriate care occurred. More efficient surgical evaluation and appropriate treatment of hemorrhage could reduce trauma morality. Large amounts of missing and incomplete clinical data suggest considerable selection bias. A major implication of this study is the importance of having a robust, prospective trauma registry to collect clinical information to increase the number of cases for review. African relevance • Correcting delays in surgical care and inappropriate treatment of hemorrhage may improve trauma outcomes. • Inadequacy of the clinical records within many low-resource settings hampers retrospective research system • The need for a robust, electronic trauma registry that collects detailed clinical information is apparent. |
| Databáze: | OpenAIRE |
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