TY  - JOUR
PY  - 2018//
TI  - Informing prehospital care planning using pilot trauma registry data in Yaoundé, Cameroon
JO  - European journal of trauma and emergency surgery
A1  - Nwanna-Nzewunwa, Obieze Chiemeka
A1  - Kouo Ngamby, Marquise
A1  - Shetter, Elinor
A1  - Etoundi Mballa, Georges Alain
A1  - Feldhaus, Isabelle
A1  - Monono, Martin Ekeke
A1  - Hyder, Adnan Ali
A1  - Dicker, Rochelle
A1  - Stevens, Kent A.
A1  - Juillard, Catherine
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - INTRODUCTION: About 54% of deaths in low- and middle-income countries (LMICs) are attributable to lack of prehospital care. The single largest contributor to the disability-adjusted life years due to poor prehospital care is injury. Despite having disproportionately high injury burdens, most LMIC trauma systems have little prehospital organization. An understanding of existing prehospital care patterns in LMICs is warranted as a precursor to strengthening prehospital systems. <br><br>METHODS: In this retrospective pilot study, we collected demographic and injury characteristics, therapeutic itinerary, and transport data of patients that were captured by the trauma registry at the Central Hospital of Yaoundé (CHY) from April 15, 2009 to October 15, 2009. Bivariate and multivariate regression analyses were used to explore relationships between care-seeking behavior, method of transport, and predictor variables. <br><br>RESULTS: The mean age was 30.2 years (95% CI [29.7, 30.7]) and 73% were male. Therapeutic itinerary was available for 97.5% of patients (N = 2855). Nearly 18.7% of patients sought care elsewhere before CHY and 82% of such visits were at district hospitals or health clinics. Moderately (OR 1.336, p = 0.009) and severely (OR 1.605, p = 0.007) injured patients were more likely to seek care elsewhere before CHY and were less likely to be discharged home after their emergency ward visit as opposed to being admitted to the hospital for further treatment (OR 0.462, p < 0.001). Commercial vehicles provided most prehospital transport (65%), while police or ambulance transported few injured patients (7%). <br><br>CONCLUSIONS: Possible areas for prehospital trauma care strengthening include training lay commercial vehicle drivers in trauma care and formalizing triage, referral, and communication protocols for prehospital care to optimize timely transfer and care while minimizing secondary injury to patients.<p />  <p>Language: en</p>
LA  - en
SN  - 1863-9933
UR  - http://dx.doi.org/10.1007/s00068-018-0939-2
ID  - ref1
ER  -