TY  - JOUR
PY  - 2019//
TI  - The burden of trauma at a district hospital in the Western Cape Province of South Africa
JO  - African journal of emergency medicine
A1  - Zaidi, Ali A.
A1  - Dixon, Julia
A1  - Lupez, Kathryn
A1  - de Vries, Shaheem
A1  - Wallis, Lee A.
A1  - Ginde, Adit
A1  - Mould-Millman, Nee-Kofi
SP  - S14
EP  - S20
VL  - 9
IS  - Suppl
N2  - BACKGROUND: Sub-Saharan Africa bears a disproportionate burden of mortality from trauma. District hospitals, although not trauma centres, play a critical role in the trauma care system by serving as frontline hospitals. However, the clinical characteristics of patients receiving trauma care in African district hospitals remains under-described and is a barrier to trauma care system development. We aim to describe the burden of trauma at district hospitals by analysing trauma patients at a prototypical district hospital emergency centre. <br><br>METHODS: An observational study was conducted in August, 2014 at Wesfleur Hospital, a district facility in the Western Cape Province of South Africa. Data were manually collected from a paper registry for all patients visiting the emergency centre. Patients with trauma were selected for further analysis. <br><br>RESULTS: Of 3299 total cases, 565 (17.1%) presented with trauma, of which 348 (61.6%) were male. Of the trauma patients, 256 (47.6%) were ages 18-34 and 298 (52.7%) presented on the weekend. Intentional injuries (assault, stab wounds, and gunshot wounds) represented 251 (44.4%) cases of trauma. There were 314 (55.6%) cases of injuries that were unintentional, including road traffic injuries. There were 144 (60%) intentionally injured patients that arrived overnight (7pm-7am). Patients with intentional injuries were three times more likely to be transferred (to higher levels of care) or admitted than patients with unintentional injuries. <br><br>CONCLUSION: This district hospital emergency centre, with a small complement of non-EM trained physicians and no trauma surgical services, cared for a high volume of trauma with over half presenting on weekends and overnight when personnel are limited. The high volume and rate of admission/ transfer of intentional injuries suggests the need for improving prehospital trauma triage and trauma referrals. The results suggest strengthening trauma care systems at and around this resource-limited district hospital in South Africa may help alleviate the high burden of post-trauma morbidity and mortality.<p />  <p>Language: en</p>
LA  - en
SN  - 2211-419X
UR  - http://dx.doi.org/10.1016/j.afjem.2019.01.007
ID  - ref1
ER  -