Chest trauma epidemiology and emergency department management in a tertiary teaching hospital in Kigali, Rwanda
Introduction: Chest trauma is a major contributor to injury morbidity and mortality, and understanding trends is a crucial part of addressing this burden in low- and middle-income countries. This study reports the characteristics and emergency department (ED) management of chest trauma patients pres...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | African Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211419X22000763 |
| _version_ | 1811182342877741056 |
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| author | Bernard Nsengiyumva Michael B. Henry Heather M. Kuntz Molly K. Estes Melanie M. Randall Mindi Guptill |
| author_facet | Bernard Nsengiyumva Michael B. Henry Heather M. Kuntz Molly K. Estes Melanie M. Randall Mindi Guptill |
| author_sort | Bernard Nsengiyumva |
| collection | DOAJ |
| description | Introduction: Chest trauma is a major contributor to injury morbidity and mortality, and understanding trends is a crucial part of addressing this burden in low- and middle-income countries. This study reports the characteristics and emergency department (ED) management of chest trauma patients presenting to Rwanda's national teaching hospital in Kigali. Methods: This descriptive analysis included a convenience sample of patients presenting to a single tertiary hospital ED with chest trauma from June to December 2017. Demographic data were collected as well as injury mechanism, thoracic and associated injuries, types of imaging obtained, and treatments performed. Chart review was conducted seven days post-admission to follow up on outcomes and additional diagnoses and interventions. Incidences were calculated with Microsoft Excel. Results: Among the 62 patients included in this study, 74% were male, and mean age was 35 years. Most patients were injured in road traffic crashes (RTCs) (68%). Common chest injuries included lung contusions (79% of cases), rib fractures (44%), and pneumothoraces (37%). Head trauma was a frequent concurrent extra-thoracic injury (61%). Diagnostic imaging primarily included E-FAST ultrasound (92%) and chest x-ray (98%). The most common therapies included painkillers (100%), intravenous fluids (89%), and non-invasive oxygen (63%), while 29% underwent invasive intervention in the form of thoracostomy. The majority of patients were admitted (81%). Pneumonia was the most common complication to occur in the first seven days (32% of admitted patients). Ultimately, 40% of patients were discharged home within seven days of presentation, 50% remained hospitalized, and 5% died. Conclusion: This study on the epidemiology of chest trauma in Rwanda can guide injury prevention and medical training priorities. Efforts should target prevention in young males and those involved in RTCs. ED physicians in Rwanda need to be prepared to diagnose and treat a variety of chest injuries with invasive and noninvasive means. |
| first_indexed | 2024-04-11T09:29:48Z |
| format | Article |
| id | doaj.art-1b0681561e064fa686c85d61e62d58d1 |
| institution | Directory Open Access Journal |
| issn | 2211-419X |
| language | English |
| last_indexed | 2024-04-11T09:29:48Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | African Journal of Emergency Medicine |
| spelling | doaj.art-1b0681561e064fa686c85d61e62d58d12022-12-22T04:31:54ZengElsevierAfrican Journal of Emergency Medicine2211-419X2022-12-01124428431Chest trauma epidemiology and emergency department management in a tertiary teaching hospital in Kigali, RwandaBernard Nsengiyumva0Michael B. Henry1Heather M. Kuntz2Molly K. Estes3Melanie M. Randall4Mindi Guptill5Department of Accident and Emergency (Head of Department), University Teaching Hospital of Butare, Huye, Rwanda; Department of Anesthesia, Emergency Medicine and Critical Care, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda; Corresponding author at:Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States; Department of Emergency Medicine, Maricopa Medical Center, Creighton University Arizona Health Education Alliance, Phoenix, Arizona, United StatesDepartment of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, United StatesDepartment of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, United StatesDepartment of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, United StatesDepartment of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, United StatesIntroduction: Chest trauma is a major contributor to injury morbidity and mortality, and understanding trends is a crucial part of addressing this burden in low- and middle-income countries. This study reports the characteristics and emergency department (ED) management of chest trauma patients presenting to Rwanda's national teaching hospital in Kigali. Methods: This descriptive analysis included a convenience sample of patients presenting to a single tertiary hospital ED with chest trauma from June to December 2017. Demographic data were collected as well as injury mechanism, thoracic and associated injuries, types of imaging obtained, and treatments performed. Chart review was conducted seven days post-admission to follow up on outcomes and additional diagnoses and interventions. Incidences were calculated with Microsoft Excel. Results: Among the 62 patients included in this study, 74% were male, and mean age was 35 years. Most patients were injured in road traffic crashes (RTCs) (68%). Common chest injuries included lung contusions (79% of cases), rib fractures (44%), and pneumothoraces (37%). Head trauma was a frequent concurrent extra-thoracic injury (61%). Diagnostic imaging primarily included E-FAST ultrasound (92%) and chest x-ray (98%). The most common therapies included painkillers (100%), intravenous fluids (89%), and non-invasive oxygen (63%), while 29% underwent invasive intervention in the form of thoracostomy. The majority of patients were admitted (81%). Pneumonia was the most common complication to occur in the first seven days (32% of admitted patients). Ultimately, 40% of patients were discharged home within seven days of presentation, 50% remained hospitalized, and 5% died. Conclusion: This study on the epidemiology of chest trauma in Rwanda can guide injury prevention and medical training priorities. Efforts should target prevention in young males and those involved in RTCs. ED physicians in Rwanda need to be prepared to diagnose and treat a variety of chest injuries with invasive and noninvasive means.http://www.sciencedirect.com/science/article/pii/S2211419X22000763Thoracic traumaChest traumaInjuriesRwandaEmergency department |
| spellingShingle | Bernard Nsengiyumva Michael B. Henry Heather M. Kuntz Molly K. Estes Melanie M. Randall Mindi Guptill Chest trauma epidemiology and emergency department management in a tertiary teaching hospital in Kigali, Rwanda African Journal of Emergency Medicine Thoracic trauma Chest trauma Injuries Rwanda Emergency department |
| title | Chest trauma epidemiology and emergency department management in a tertiary teaching hospital in Kigali, Rwanda |
| title_full | Chest trauma epidemiology and emergency department management in a tertiary teaching hospital in Kigali, Rwanda |
| title_fullStr | Chest trauma epidemiology and emergency department management in a tertiary teaching hospital in Kigali, Rwanda |
| title_full_unstemmed | Chest trauma epidemiology and emergency department management in a tertiary teaching hospital in Kigali, Rwanda |
| title_short | Chest trauma epidemiology and emergency department management in a tertiary teaching hospital in Kigali, Rwanda |
| title_sort | chest trauma epidemiology and emergency department management in a tertiary teaching hospital in kigali rwanda |
| topic | Thoracic trauma Chest trauma Injuries Rwanda Emergency department |
| url | http://www.sciencedirect.com/science/article/pii/S2211419X22000763 |
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