Hospital-based trauma registries in Uganda

Abstract

Objectives: Toward the establishment of an injury surveillance system in Uganda, the first step was to initiate hospital-based trauma registries that generate relevant and timely data on the causes, severity, morbidity, mortality, and outcomes of injuries at Mulago and Kawolo hospitals. This would help establish injury patterns and priorities in these hospital populations. The registries are based on a minimal data set and a new injury severity instrument, the Kampala Trauma Score (KTS). The usefulness of the registry and the qualities of the KTS are presented.

Methods: The Accident and Emergency Department of Mulago, an urban 1,500-bed, tertiary hospital, and the Casualty Unit of Kawolo, a 100-bed district-level hospital. Trained staff in the hospitals used a one-page, 19-item registry form to collect data on demographic, injury incident, and outcome data. The registry describes injuries based on cause, frequency, and severity. The inter-rater reliability and the predictive validity of the KTS were evaluated. Registry subjects include all injured persons that come to the above hospitals.

Results: Results are based on the first 5,210 records. Gender distribution was 27.7% female and 71.3% male. The younger than 5 years old category was 7.4%, whereas 3.9% were older than 55 years old. Admitted patients composed 37.3% of cases, and three of four injuries were unintentional. The KTS is highly predictive of need for admission or death (adults, Az = 0.95 +/- 0.01; children, Az = 0.89 +/- 0.01).

Conclusion: A trauma registry and injury severity measurement are both possible and useful in sub-Saharan Africa. This minimal data set and the KTS are recommended for investigators with similar resource constraints.