Elizabeth Lutge1, Nirvasha Moodley2, Aida Tefera3, Benn Sartorius4, Timothy Hardcastle5, Damian Clarke6. 1. Epidemiology Unit, KZN Department of Health, P/Bag X9051, Pietermaritzburg 3200, South Africa; Department of Public Health, University of KwaZulu-Natal, School of Nursing and Public Health, Durban, South Africa. Electronic address: elizabeth.lutge@kznhealth.gov.za. 2. Data Management Unit, KZN Department of Health, P/Bag X9051, Pietermaritzburg 3200, South Africa. Electronic address: nirvasha.narayan@kznhealth.gov.za. 3. Epidemiology Unit, KZN Department of Health, P/Bag X9051, Pietermaritzburg 3200, South Africa. Electronic address: Aida.tefera@kznhealth.gov.za. 4. Department of Public Health, University of KwaZulu-Natal, School of Nursing and Public Health, Durban, South Africa. Electronic address: sartorius@ukzn.ac.za. 5. Trauma Service, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; Department of Surgery, University of KwaZulu-Natal, Durban, South Africa. Electronic address: timothyhar@ialch.co.za. 6. Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, South Africa; Department of Surgery, University of KwaZulu-Natal, Durban, South Africa. Electronic address: damianclar@gmail.com.
Abstract
INTRODUCTION: In response to the ongoing excessive burden of trauma in South Africa the Data Management and Epidemiology Units of the Department of Health in conjunction with a group of trauma specialists developed a number of trauma data variables for inclusion on the routine District Health Information System (DHIS). The aim of this study is to describe the process followed and review the 2012-2014 data. METHODOLOGY: The variables collected included: total patient numbers assessed in the emergency room with a diagnosis of trauma; the mechanisms of trauma (blunt assault, motor vehicle accident, pedestrian vehicle accident, stab, gunshot wound, other); any trauma patient admitted to a health facility ward/ICU for longer than 12h; and whether the patient required transfer to a higher centre of care. All trauma deaths in hospital were recorded. The severity of trauma was measured using the Emergency Medical Services (EMS) classification of blue code (dead), red code (stretcher case with deranged physiology), yellow code (stretcher case with normal physiology) and green code (able to walk with normal physiology. The DHIS trauma data from April 2012 to March 2014 was reviewed. RESULTS: There were 197,219 emergency room visits for trauma in KZN in the 2013/2014 financial year. This constitutes 27.0% of all emergency room visits. The ratio of intentional to non-intentional injury is 45:55. There were 18,716 admissions to public sector hospitals for trauma in KZN in the 2013/2014 financial year. This constitutes 2.4% of all admissions in the province. There were 1045 inpatient deaths due to trauma in the same period, constituting 2.5% of all inpatient deaths. The overall rate of trauma in KZN was 17 per 1000 population. CONCLUSION: The adapted DHIS has successfully collected essential data that quantify the hospital burden of trauma in KZN province. This has provided the most complete overview of the burden of trauma in the Province. These trauma indicators should remain a permanent part of the DHIS to allow planners to track the trauma epidemic and to institute informed management strategies.
INTRODUCTION: In response to the ongoing excessive burden of trauma in South Africa the Data Management and Epidemiology Units of the Department of Health in conjunction with a group of trauma specialists developed a number of trauma data variables for inclusion on the routine District Health Information System (DHIS). The aim of this study is to describe the process followed and review the 2012-2014 data. METHODOLOGY: The variables collected included: total patient numbers assessed in the emergency room with a diagnosis of trauma; the mechanisms of trauma (blunt assault, motor vehicle accident, pedestrian vehicle accident, stab, gunshot wound, other); any traumapatient admitted to a health facility ward/ICU for longer than 12h; and whether the patient required transfer to a higher centre of care. All trauma deaths in hospital were recorded. The severity of trauma was measured using the Emergency Medical Services (EMS) classification of blue code (dead), red code (stretcher case with deranged physiology), yellow code (stretcher case with normal physiology) and green code (able to walk with normal physiology. The DHIS trauma data from April 2012 to March 2014 was reviewed. RESULTS: There were 197,219 emergency room visits for trauma in KZN in the 2013/2014 financial year. This constitutes 27.0% of all emergency room visits. The ratio of intentional to non-intentional injury is 45:55. There were 18,716 admissions to public sector hospitals for trauma in KZN in the 2013/2014 financial year. This constitutes 2.4% of all admissions in the province. There were 1045 inpatient deaths due to trauma in the same period, constituting 2.5% of all inpatient deaths. The overall rate of trauma in KZN was 17 per 1000 population. CONCLUSION: The adapted DHIS has successfully collected essential data that quantify the hospital burden of trauma in KZN province. This has provided the most complete overview of the burden of trauma in the Province. These trauma indicators should remain a permanent part of the DHIS to allow planners to track the trauma epidemic and to institute informed management strategies.
Authors: M M Donovan; V Y Kong; J L Bruce; G L Laing; W Bekker; V Manchev; M Smith; D L Clarke Journal: World J Surg Date: 2019-04 Impact factor: 3.352
Authors: Ibrahim Bundu; Richard Lowsby; Hassan P Vandy; Suleiman P Kamara; Abdul Malik Jalloh; Christella O S Scott; Fenella Beynon Journal: Afr J Emerg Med Date: 2018-07-27
Authors: Ali A Zaidi; Julia Dixon; Kathryn Lupez; Shaheem De Vries; Lee A Wallis; Adit Ginde; Nee-Kofi Mould-Millman Journal: Afr J Emerg Med Date: 2019-01-19