DELAYS IN HOSPITAL PRESENTATION AND OPERATIVE INTERVENTION FOR TRAUMATIC INJURY AT A MAJOR TRAUMA HOSPITAL IN ADDIS ABABA ETHIOPIA stephanie.presser@yale.edu

 

DELAYS IN HOSPITAL PRESENTATION AND OPERATIVE INTERVENTION FOR TRAUMATIC INJURY AT A MAJOR TRAUMA HOSPITAL IN ADDIS ABABA ETHIOPIA

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United States

Oral or Poster

Timely intervention, a central tenant of trauma care, is often challenging in low- and middle-income countries. This study evaluates time to care for surgical trauma at a trauma center in Ethiopia.

A WHO trauma registry, established at one of the primary trauma hospitals in 2021, was queried to identify adult patients who underwent operations following injury. Charts for these surgical trauma patients were abstracted. Time to care points were analyzed by specialty, operative type, Glasgow Come Scale (GCS), shock categorization, and disposition.

Of the 11,279 adult patients in the registry, 433 had surgical procedures. The median time of presentation after injury was 4.7 hours and median time from arrival to operation was over 52 hours. Patients in the fastest quartile were taken within 21.5 hours whereas the slowest quartile waited over 145 hours (IQR 124.2 hours). Neurosurgical cases were taken to the operating room fastest (p50 20.5 hours, IQR 31.8 hours) followed by general surgery (p50 29.42 hours, IQR 50.7 hours). Orthopedic and spine patients generally waited longer (p50 75.8 and 97.25 hours, IQR 145.7 hours and 110.2 hours, respectively). No significant differences were found for mechanism of injury, arrival method, class of shock, and GCS.

Trauma patients in this study face delays in surgical care, with a median wait time of over two days. Procedure type is most significantly associated with differences in time to surgical intervention. Further investigation is needed to understand the reasons behind these lengthy delays, and to identify targets for interventions.