Trauma admissions into the intensive care unit and outcome of care in a tertiary health facility

Abstract

Background: Trauma remains a leading cause of morbidity and mortality in resource challenged economies I. In Nigeria, the number of deaths due to trauma-induced injuries is on the rise. Major trauma victims are usually from road traffic accidents and are managed at the accident and emergency unit while the severe ones are admitted into the intensive care unit.

Methodology: All trauma admissions to the intensive care unit (ICU) of LAUTECHTeaching Hospital Osogbo over a 5 year period (2008-2012) after ethical approval from the ethical unit of the hospital were reviewed.

Results: During the study period, 112 trauma patients were admitted to the ICU, representing 68% of total ICU admissions. The male:female ratio of ICU trauma cases was 3:1. Out of the trauma admissions 83 (74.1%) of the cases came as emergency from the accident and emergency unit while 2.4% and 1.6% respectively came from operating theatre-- and the general ward respectively. 83 (74.1%) of trauma cases admitted were road traffic accidents, while 20 (17.9%) were burns not related to RTA and the remaining 8(9%) were due to falls, fight/ssault. Most of the road traffic accidents related trauma patients admitted to the intensive care unit had head injuries (66.3%) while 7% and 12% had multiple fractures and chest injuries respectively. The mean patient age 35 years and the mean duration of ICU stay was 6.3 ± 8.4 days. Survivors had a longer ICU stay

Conclusion: Trauma is a major cause of hospitalization and intensive care utilization. It also consumes a significant amount of the health care budget.In most instances it is preventtable.Trauma prevention, the most effective management strategy should include increased public education, improved security, better implementation of legislative measures to ensure safety for all road users, control of firearms, and minimizing domestic and intentional violence. Appropriate, aggressive intensive care in combination with efficient communications,rapid medical evacuation, and an organized emergency multidisciplinary trauma care team will further improve outcome in trauma patients.