TY  - JOUR
PY  - 2019//
TI  - Retrospective review of the patient cases at a major trauma center in Nairobi, Kenya and implications for emergency care development
JO  - African journal of emergency medicine
A1  - Saleeby, Julie
A1  - Myers, Justin G.
A1  - Ekernas, Karen
A1  - Hunold, Katherine
A1  - Wangara, Ali
A1  - Maingi, Alice
A1  - Wilson, Peyton
A1  - Mutiso, Vincent
A1  - Zamamiri, Sarah
A1  - Bacon, Daniel
A1  - Davis, Wes
A1  - Suder, John
A1  - Agrawal, Yash
A1  - Ogar, Ogar
A1  - Martin, Ian B. K.
A1  - Dunlop, Stephen
SP  - 127
EP  - 133
VL  - 9
IS  - 3
N2  - INTRODUCTION: Low- and middle-income countries (LMICs) are continuing to experience a "triple burden" of disease - traumatic injury, non-communicable diseases (NCDs), and communicable disease with maternal and neonatal conditions (CD&Ms). The epidemiology of this triad is not well characterised and poses significant challenges to resource allocations, administration, and education of emergency care providers. The data collected in this study provide a comprehensive description of the emergency centre at Kenya's largest public tertiary care hospital. <br><br>METHODS: This study is a retrospective chart review conducted at Kenyatta National Hospital of all patient encounters over a four-month period. Data were collected from financial and emergency centre triage records along with admission and mortality logbooks. Chief complaints and discharge diagnoses collected by specially trained research assistants were manually converted to standardised diagnoses using International Classification of Disease 10 (ICD-10) codes. ICD-10 codes were categorised into groups based on the ICD-10 classification system for presentation. <br><br>RESULTS: A total of 23,941 patients presented to the emergency centre during the study period for an estimated annual census of 71,823. The majority of patients were aged 18-64 years (58%) with 50% of patients being male and only 3% of unknown sex. The majority of patients (61%) were treated in the emergency centre, observed, and discharged home. Admission was the next most common disposition (33%) followed by death (6%). Head injury was the overall most common diagnosis (11%) associated with admission. <br><br>CONCLUSIONS: Trends toward NCDs and traumatic diseases have been described by this study and merit further investigation in both the urban and rural setting. Specifically, the significance of head injury on healthcare cost, utilisation, and patient death and disability points to the growing need of additional resources at Kenyatta National Hospital for acute care. It further demonstrates the mounting impact of trauma in Kenya and throughout the developing world.<p />  <p>Language: en</p>
LA  - en
SN  - 2211-419X
UR  - http://dx.doi.org/10.1016/j.afjem.2019.05.002
ID  - ref1
ER  -