@article{ref1,
title="Hospital Mortality Following Trauma: An Analysis of a Hospital-Based Injury Surveillance Registry in sub-Saharan Africa",
journal="Journal of Surgical Education",
year="2014",
author="Tyson, Anna F. and Varela, Carlos and Cairns, Bruce A. and Charles, Anthony G.",
volume="72",
number="4",
pages="e66-72",
abstract="IMPORTANCE: Injuries are a significant cause of death and disability, particularly in low- and middle-income countries. Health care systems in resource-poor countries lack personnel and are ill equipped to treat severely injured patients; therefore, many injury-related deaths occur after hospital admission. <br><br>OBJECTIVES: This study evaluates the mortality for hospitalized trauma patients at a tertiary care hospital in Malawi. <br><br>DESIGN: This study is a retrospective analysis of prospectively collected trauma surveillance data. We performed univariate and bivariate analyses to describe the population and logistic regression analysis to identify predictors of mortality. SETTING: Tertiary care hospital in sub-Saharan Africa. PARTICIPANT: Patients with traumatic injuries admitted to Kamuzu Central Hospital between January 2010 and December 2012. MAIN OUTCOME MEASURES: Predictors of in-hospital mortality. <br><br>RESULTS: The study population consisted of 7559 patients, with an average age of 27 years (±18 years) and a male predominance of 76%. Road traffic injuries, falls, and assaults were the most common causes of injury. The overall mortality was 4.2%. After adjusting for age, sex, type and mechanism of injury, and shock index, head/spine injuries had the highest odds of mortality, with an odds ratio of 5.80 (2.71-12.40). <br><br>CONCLUSION AND RELEVANCE: The burden of injuries in sub-Saharan Africa remains high. At this institution, road traffic injuries are the leading cause of injury and injury-related death. The most significant predictor of in-hospital mortality is the presence of head or spinal injury. These findings may be mitigated by a comprehensive injury-prevention effort targeting drivers and other road users and by increased attention and resources dedicated to the treatment of patients with head and/or spine injuries in the hospital setting.<p /><p>Language: en</p>",
language="en",
issn="1931-7204",
doi="10.1016/j.jsurg.2014.09.010",
url="http://dx.doi.org/10.1016/j.jsurg.2014.09.010"
}