000			02849nam a22001697a 4500
008			210820b |||||||| |||| 00| 0 eng d
100			_aLazaro, Kajanja _dCUHAS/6000079/T/10 _922603
245			_aPredictors of case fatality and length of hospital stay of patients with major limb trauma at Bugando Medical Centre in Mwanza, Tanzania
260			_aMwanza, Tanzania: _bCatholic University of Health and Allied Sciences CUHAS - Bugando _c©2013
300			_aiv; 74 Pages
300			_aIncludes References and Appendices
520			_aAbstract: Background: Major limb trauma constitutes a public health problem of great importance worldwide and is associated with high fatality, morbidity and long-term disabilities. This study was conducted to determine the predictors of case fatality and length of hospital stay of patients with major limb trauma attending Bugando Medical Centre (BMC), Mwanza Tanzania. Methods: this was a cross-section study of patients with limb trauma which was conducted at the Causality and Emergency department of BMC. The diagnosis of major limb trauma was made by clinical history, physical examination, injury severity score and radiological investigations. Patients were followed up for any in-hospital complications during the study period. Results: A total of 250 patients were enrolled whereby 83.6% of the patient were between 12 and 45 years and 16.4% (41/250) were above 45 years of the enrolled patients, 70.0% (175/250) were male. Of the 250 emrolled patients, 43 patients (17.2%) died within two weeks. One hundred and fifty two patients (60.8%) had prolonged hospital stay of more than two weeks. Presence of other injuries, (OR=4.1; 95% CI=1.1-14.6; P=0.032), injury severity score of >18 (OR=3.5; 95% CI=1.1-11.4; P=0.038) and platelet count of <150x109 cell/l (OR=9.1; 95%CI=2.9-28.5, P<0.001) were independent predictors of death. Injury-treatment time interval of >24 hours (OR=5.5 95% CI [2.7-11.6], P<0.001), admission random, blood glucose level of >10 mmol/l (OR 11.4 95% CI [3.4-38.4], P<0.001) and admission white blood cell count of >11x109cells/l (OR=0.1; 95% CI=0.01-0.2, P<0.001) were independent predictors of long hospital stay. Conclusion: Major limb trauma is a fatal condition with a high case fatality rate. Presence of other injuries than limb injury, injury severity score>18 and admission platelet count<150x109cells/L are independent predictors of in-hospital case fatality. Injury severity score, full blood picture, random blood glucose and injury-treatment interval are crucial parameters in all trauma patients so as to classify cases that need aggressive treatment to reduce the chances for early in-hospital deaths and prolonged hospital stay.
654			_xSurgery
700			_aJaphet M. Gilyoma _922731
700			_aPhilipo. L. Chalya _944521
942			_2ddc _cMP
999			_c18325 _d18325