Outcome for hospitalized road trauma patients at a tertiary hospital in Kenya

Background: The developing world continues to experience a disproportionate burden of injury. About one half of injury deaths are due to motor vehicle collisions. Road traffic fatalities per 10,000 vehicles are ten to 20 times higher in Africa compared to Europe. Patients and Methods: 233 patients were consecutively analyzed. Injury acuity was determined by calculating Injury Severity Scores (ISS) for each patient. Information on the care and treatment outcome was obtained from patient interviews, case notes and discharge summaries. Data analysis was performed using the SPSS version 10.0 statistical software. Results: Injury accounted for 48.8% of all emergency hospitalizations into the surgical units. Injury due to traffic comprised a third (31%) of trauma admissions. Injuries to the limbs were predominant (54%). Acuity ranged from ISS 1 to 43. The mean ISS was 8.78. Major injury (ISS > 15) constituted 13% of all the admissions. Operating room resources were utilized in 52% of the patients (major operations were performed in 12% of this group). The overall complication rate was 12.0%. Although the overall mortality amounted to 6%, mortality was 35.6% amongst those with major injury. It was also higher with associated head injury, pedestrian injury and weekend injury. Conclusion: The overall trauma acuity was moderate injury. Mortality escalated to 35% for major injury. There is need to explore the factors contributing to this high mortality and a system of care that can optimize outcome.