Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda

Introduction: Traumatic injuries disproportionately affect populations in low and middle-income countries (LMIC) where head injuries predominate. The Rwandan Ministry of Health (MOH) has dramatically improved access to emergency services by rebuilding its health infrastructure. The MOH has strengthe...

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Autores principales:	Naz Karim, Lise Mumporeze, Vizir J.P. Nsengimana, Ashley Gray, Alexis Kearney, Adam R. Aluisio, Zeta Mutabazi, Janette Baird, Camille M. Clancy, Derek Lubetkin, Jean Eric Uwitonze, Jeanne D’Arc Nyinawankusi, Menelas Nkeshimana, Jean Claude Byiringiro, Adam C. Levine
Formato:	article
Lenguaje:	EN
Publicado:	eScholarship Publishing, University of California 2021
Materias:	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/0e4995b8cf3b4876b46ae6a4a773c629
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spelling	oai:doaj.org-article:0e4995b8cf3b4876b46ae6a4a773c6292021-11-17T15:19:27ZEpidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda1936-901810.5811/westjem.2021.4.50961https://doaj.org/article/0e4995b8cf3b4876b46ae6a4a773c6292021-09-01T00:00:00Zhttps://escholarship.org/uc/item/7z5588cnhttps://doaj.org/toc/1936-9018Introduction: Traumatic injuries disproportionately affect populations in low and middle-income countries (LMIC) where head injuries predominate. The Rwandan Ministry of Health (MOH) has dramatically improved access to emergency services by rebuilding its health infrastructure. The MOH has strengthened the nation’s acute emergency response by renovating emergency departments (ED), developing the field of emergency medicine as a specialty, and establishing a prehospital care service: Service d’Aide Medicale Urgente (SAMU). Despite the prevalence of traumatic injury in LMIC and the evolving emergency service in Rwanda, data regarding head trauma epidemiology is lacking. Methods: We conducted this retrospective cohort study at the University Teaching Hospital of Kigali (UTH-K) and used a linked prehospital database to investigate the demographics, mechanism, and degree of acute medical interventions amongst prehospital patients with head injury. Results: Of the 2,426 patients transported by SAMU during the study period, 1,669 were found to have traumatic injuries. Data from 945 prehospital patients were accrued, with 534 (56.5%) of these patients diagnosed with a head injury. The median age was 30 years, with most patients being male (80.3%). Motor vehicle collisions accounted for almost 78% of all head injuries. One in six head injuries were due to a pedestrian struck by a vehicle. Emergency department interventions included intubations (6.7%), intravenous fluids (2.4%), and oxygen administration (4.9%). Alcohol use was not evaluated or could not be confirmed in 81.3% of head injury cases. The median length of stay (LOS) in the ED was two days (interquartile range: 1,3). A total of 184 patients were admitted, with 13% requiring craniotomies; their median in-hospital care duration was 13 days. Conclusion: In this cohort of Rwandan trauma patients, head injury was most prevalent amongst males and pedestrians. Alcohol use was not evaluated in the majority of patients. These traumatic patterns were predominantly due to road traffic injury, suggesting that interventions addressing the prevention of this mechanism, and treatment of head injury, may be beneficial in the Rwandan setting.Naz KarimLise MumporezeVizir J.P. NsengimanaAshley GrayAlexis KearneyAdam R. AluisioZeta MutabaziJanette BairdCamille M. ClancyDerek LubetkinJean Eric UwitonzeJeanne D’Arc NyinawankusiMenelas NkeshimanaJean Claude ByiringiroAdam C. LevineeScholarship Publishing, University of CaliforniaarticleMedicineRMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENWestern Journal of Emergency Medicine, Vol 22, Iss 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Naz Karim Lise Mumporeze Vizir J.P. Nsengimana Ashley Gray Alexis Kearney Adam R. Aluisio Zeta Mutabazi Janette Baird Camille M. Clancy Derek Lubetkin Jean Eric Uwitonze Jeanne D’Arc Nyinawankusi Menelas Nkeshimana Jean Claude Byiringiro Adam C. Levine Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda
description	Introduction: Traumatic injuries disproportionately affect populations in low and middle-income countries (LMIC) where head injuries predominate. The Rwandan Ministry of Health (MOH) has dramatically improved access to emergency services by rebuilding its health infrastructure. The MOH has strengthened the nation’s acute emergency response by renovating emergency departments (ED), developing the field of emergency medicine as a specialty, and establishing a prehospital care service: Service d’Aide Medicale Urgente (SAMU). Despite the prevalence of traumatic injury in LMIC and the evolving emergency service in Rwanda, data regarding head trauma epidemiology is lacking. Methods: We conducted this retrospective cohort study at the University Teaching Hospital of Kigali (UTH-K) and used a linked prehospital database to investigate the demographics, mechanism, and degree of acute medical interventions amongst prehospital patients with head injury. Results: Of the 2,426 patients transported by SAMU during the study period, 1,669 were found to have traumatic injuries. Data from 945 prehospital patients were accrued, with 534 (56.5%) of these patients diagnosed with a head injury. The median age was 30 years, with most patients being male (80.3%). Motor vehicle collisions accounted for almost 78% of all head injuries. One in six head injuries were due to a pedestrian struck by a vehicle. Emergency department interventions included intubations (6.7%), intravenous fluids (2.4%), and oxygen administration (4.9%). Alcohol use was not evaluated or could not be confirmed in 81.3% of head injury cases. The median length of stay (LOS) in the ED was two days (interquartile range: 1,3). A total of 184 patients were admitted, with 13% requiring craniotomies; their median in-hospital care duration was 13 days. Conclusion: In this cohort of Rwandan trauma patients, head injury was most prevalent amongst males and pedestrians. Alcohol use was not evaluated in the majority of patients. These traumatic patterns were predominantly due to road traffic injury, suggesting that interventions addressing the prevention of this mechanism, and treatment of head injury, may be beneficial in the Rwandan setting.
format	article
author	Naz Karim Lise Mumporeze Vizir J.P. Nsengimana Ashley Gray Alexis Kearney Adam R. Aluisio Zeta Mutabazi Janette Baird Camille M. Clancy Derek Lubetkin Jean Eric Uwitonze Jeanne D’Arc Nyinawankusi Menelas Nkeshimana Jean Claude Byiringiro Adam C. Levine
author_facet	Naz Karim Lise Mumporeze Vizir J.P. Nsengimana Ashley Gray Alexis Kearney Adam R. Aluisio Zeta Mutabazi Janette Baird Camille M. Clancy Derek Lubetkin Jean Eric Uwitonze Jeanne D’Arc Nyinawankusi Menelas Nkeshimana Jean Claude Byiringiro Adam C. Levine
author_sort	Naz Karim
title	Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda
title_short	Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda
title_full	Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda
title_fullStr	Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda
title_full_unstemmed	Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda
title_sort	epidemiology of patients with head injury at a tertiary hospital in rwanda
publisher	eScholarship Publishing, University of California
publishDate	2021
url	https://doaj.org/article/0e4995b8cf3b4876b46ae6a4a773c629
work_keys_str_mv	AT nazkarim epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT lisemumporeze epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT vizirjpnsengimana epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT ashleygray epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT alexiskearney epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT adamraluisio epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT zetamutabazi epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT janettebaird epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT camillemclancy epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT dereklubetkin epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT jeanericuwitonze epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT jeannedarcnyinawankusi epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT menelasnkeshimana epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT jeanclaudebyiringiro epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda AT adamclevine epidemiologyofpatientswithheadinjuryatatertiaryhospitalinrwanda
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Epidemiology of Patients with Head Injury at a Tertiary Hospital in Rwanda

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