THREE-MONTH MORTALITY AND DISABILITY AFTER MODERATE TO SEVERE INJURIES IN FOUR LOW- OR MIDDLE-INCOME COUNTRIES leila.ghalichi@gmail.com

433-02

THREE-MONTH MORTALITY AND DISABILITY AFTER MODERATE TO SEVERE INJURIES IN FOUR LOW- OR MIDDLE-INCOME COUNTRIES

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United Kingdom

Oral only

Burden of mortality or disability after injury is high in LMICs. Little is known about these outcomes among those who reach healthcare, or the determinants of disparity in the outcomes.

Patients admitted to 19 hospitals in Pakistan, Ghana, Rwanda and South Africa, selected as contextually diverse countries, with moderate to severe injuries were followed up until three months after discharge. A multivariable model was used to assess associations with outcomes at 3 months after discharge.

From 9,720 eligible patients, 8687 were followed up until death or discharge and 6213 to 3 months. Median age was 31 (IQR: 20,43) years;76.8% were males. In hospital mortality was suffered by 6.1% (531/8687). Three-month post-discharge mortality or disability occurred in 47.6% (2,476/5199). Three-months post discharge, mortality was 9.9% (616/ 6213) and disability was 40.6% (1860/4583). Three-month post-discharge mortality or morbidity increased with arriving to facilities by ambulance, within the first hour after injury, without visiting another facility; having orthopaedic injuries, increasing age and being poor. Similar results were observed for disability. Odds of mortality was associated with arrival by ambulance, without visiting another facility, being admitted to a tertiary hospital; age, lack of education, injury severity, and suffering neurotrauma.

Burden of mortality or disability after reaching care in LMICs is high. High odds of outcomes after arrival by ambulance, within the first hour, or to a tertiary facility might be explained by people with more severe injuries taking this pathway.