TY  - JOUR
PY  - 2017//
TI  - Variations in injury characteristics among paediatric patients following trauma: a retrospective descriptive analysis comparing pre-hospital and in-hospital deaths at Kamuzu Central Hospital, Lilongwe, Malawi
JO  - Malawi medical journal
A1  - Purcell, Laura
A1  - Mabedi, Charles E.
A1  - Gallaher, Jared
A1  - Mjuweni, Steven
A1  - McLean, Sean
A1  - Cairns, Bruce
A1  - Charles, Anthony
SP  - 146
EP  - 150
VL  - 29
IS  - 2
N2  - BACKGROUND: Trauma is a major cause of paediatric mortality in sub-Saharan Africa. In absence of pre-hospital care, the injury mechanism and cause of death is difficult to characterise. Injury characteristics of pre-hospital deaths (PHD) versus in-hospital deaths (IHD) were compared. <br><br>METHODS: Using our trauma surveillance database, a retrospective, descriptive analysis of children (<18 years) presenting to Kamuzu Central Hospital in Lilongwe, Malawi from 2008 to 2013 was performed. Patient and injury characteristics of pre-hospital and in-hospital deaths were compared with univariate and bivariate analysis. <br><br>RESULTS: Of 30,462 paediatric trauma patients presenting between 2008 and 2013, 170 and 173 were PHD and IHD, respectively. In PHD and IHD patients mean age was 7.3±4.9 v 5.2±4.3 (p<0.001), respectively. IHD patients were more likely transported via ambulance than those PHD, 51.2% v 8.3% (p<0.001). The primary mechanisms of injury for PHD were road traffic injuries (RTI) (45.8%) and drowning (22.0%), with head injury (46.7%) being the predominant cause of death. Burns were the leading mechanism of injury (61.8%) and cause of death (61.9%) in IHD, with a mean total body surface area involvement of 24.7±16.0%. <br><br>CONCLUSIONS: RTI remains Malawi's major driver of paediatric mortality. A majority of these deaths attributed to head injury occur prior to hospitalisation; therefore the mortality burden is underestimated if accounting for IHD alone. Death in burn patients is likely due to under-resuscitation or sepsis. Improving pre-hospital care and head injury and burn management can improve injury related paediatric mortality.<p />  <p>Language: en</p>
LA  - en
SN  - 1995-7262
UR  - http://dx.doi.org/
ID  - ref1
ER  -