Key findings from a prospective trauma registry at a regional hospital in Southwest Cameroon

IntroductionTrauma is a leading cause of morbidity and mortality worldwide. Data characterizing the burden of trauma in Cameroon is limited. Regular, prospective injury surveillance can address the shortcomings of existing hospital administrative logs and medical records. This study aims to characterize trauma as seen at the emergency department (ED) of Limbe Regional Hospital (LRH) and assess the completeness of data obtained by a trauma registry.Methods and findingsFrom January 2008 to October 2013, we prospectively captured data on injured patients using a strategically designed, context-relevant trauma registry instrument. Indicators around patient demographics, injury characteristics, delays in accessing care, and treatment outcomes were recorded. Descriptive, bivariate, and multivariate statistical analyses were conducted.About 5,617 patients, aged from 0.5-95years (median age of 26 years), visited the LRH ED with an injury; 67% were male. Students (27%) were the most affected occupation category. Road traffic injuries (RTIs) (56%), assault (22%), and domestic injuries (13%) were the leading causes of injury. Two-thirds of RTIs were motorcycle-related. Working in transportation (AOR 4.42, pConclusionsImplementation of a context-appropriate trauma registry in resource-constrained settings is feasible. Providing valuable, high-quality data, the trauma registry can inform trauma care quality improvement efforts and policy development. Study findings indicate the need for injury prevention interventions and policies that will prioritize high-risks groups, such as those aged 20–29 years, and those in occupations requiring frequent road travel. The high incidence of motorcycle-related injuries is concerning and calls for a proactive solution.

引言
创伤是全球范围内导致发病与死亡的首要病因之一。目前关于喀麦隆创伤负担的特征性数据较为匮乏。定期开展的前瞻性损伤监测可弥补现有医院行政日志与医疗记录的不足。本研究旨在对林贝地区医院（Limbe Regional Hospital, LRH）急诊科室（Emergency Department, ED）接诊的创伤病例进行特征分析，并评估创伤登记系统（trauma registry）所获数据的完整性。
研究方法与结果
2008年1月至2013年10月期间，本研究采用经策略性设计、贴合当地场景的创伤登记工具，前瞻性收集损伤患者的相关数据。记录内容涵盖患者人口学特征、损伤特点、就医延误情况及治疗结局等指标。本研究采用描述性统计、双变量统计及多变量统计分析方法开展数据分析。
本研究共纳入5617例因损伤就诊于LRH急诊科室的患者，患者年龄介于0.5~95岁之间，中位年龄为26岁，其中男性占比67%。学生（27%）为受影响最显著的职业群体。道路交通损伤（Road Traffic Injuries, RTIs，占比56%）、攻击伤（占比22%）与居家损伤（占比13%）为最主要的损伤诱因。三分之二的道路交通损伤与摩托车相关。运输行业从业者的损伤风险显著升高（调整优势比（Adjusted Odds Ratio, AOR）=4.42，P值[原文未完整呈现]）。
研究结论
在资源受限地区推行贴合当地场景的创伤登记系统具备可行性。该创伤登记系统可提供高质量且具有参考价值的数据，为创伤诊疗质量提升工作与相关政策制定提供科学依据。本研究结果显示，需针对高风险群体制定损伤预防干预措施与配套政策，例如20~29岁年龄段人群，以及需频繁开展公路出行的职业人群。摩托车相关损伤的高发生率令人担忧，亟需出台主动防控方案。