Pattern and trend of trauma related deaths in the Emergency Medicine department of Tikur Anbessa Specialized teaching hospital, 2014-2016

Abstract

Background: Trauma is a major global public health problem, accounting for approximately 10% of all deaths worldwide. Although timely prehospital care has been shown to reduce trauma-related mortality, such services remain limited in many low- and middle-income countries, including Ethiopia. Data on trauma-related deaths and prehospital care are limited. This study assessed the patterns of trauma-related deaths presenting to the Emergency Department (ED) of Tikur Anbessa Specialized Hospital (TASH).

Methods: A retrospective descriptive study was conducted at the ED of TASH. Medical records and trauma sheets of all eligible trauma-related deaths occurring between April 2014 and September 2016 were reviewed. Patients who arrived alive at the ED and subsequently died from traumatic injuries, excluding burns and poisoning, were included. Data were analyzed using SPSS version 20. Descriptive statistics were summarized using frequencies, percentages, means, tables, and figures.

Results: Males accounted for most trauma-related deaths (84.8%, 80.6%, and 83.9%) across the three study periods. Trauma-related deaths represented 17.6%, 13.9%, and 10.9% of all ED deaths, respectively. Only 45.6%, 27.8%, and 25.8% of patients arrived within six hours of injury. Motor vehicle accidents were the leading mechanism of injury (65.2%, 55.6%, and 80.6%), followed by assault and falls. Blunt trauma was the predominant injury type, and blunt head injury was the most common anatomical injury. The mean Revised Trauma Score ranged from 5.02 ± 1.77 to 5.43 ± 1.90. Head injury was the leading cause of death, followed by sepsis/multiple organ failure syndrome, hemorrhagic shock, and respiratory failure.

Conclusion: Trauma-related deaths predominantly affected males of productive age. Delayed presentation to hospital was common, and motor vehicle accidents remained the leading cause of death despite an overall decline in trauma-related mortality. Strengthening injury prevention strategies, prehospital emergency services, and hospital trauma care may help reduce preventable trauma-related deaths in Ethiopia.