Teaching hospital perspective of the quality of trauma care in Lagos, Nigeria.

Information including respiratory rate, blood pressure, Glasgow Coma Scale, and anatomic injuries were obtained for all injured patients consecutively admitted to the Lagos University Teaching Hospital (LUTH) during the 9-month period from September 1995 to May 1996. The data were analyzed using the UK Major Trauma Outcome Study (MTOS) methodology. The Revised Trauma Score (RTS), the Injury Severity Score (ISS), and the Probability of Survival (Ps) were calculated for each patient. In addition, the "M," "z," and "w" scores were calculated for blunt injuries. Of the 253 patients (median age 28 years; male/female ratio 4:1) studied, 85% suffered blunt trauma, 75% of which were due to RTA. About 60% of RTA victims were pedestrians. Only 8% of nonpedestrian victims wore protective devices. The mean ISS was 10, the mean RTS 6.98, and the mean Ps 0.96. The "m" statistic for blunt trauma was 0.91, and there were 122 survivors compared to the 163 predicted. The "z" and "w" scores were -18.49 and -24.55, respectively. Altogether, 42.7% of patients with ISS > 15 and 40.7% with RTS < 7.5 died. According to these results, the severity of injuries encountered in Lagos is comparable to those reported from the United Kingdom and the United States, but the death rate is higher.