The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approach
Introduction: The purpose of the study was to determine the preventable trauma-related death rate (PDR) at Komfo Anokye Teaching Hospital in Kumasi, Ghana three years after initiation of an Emergency Medicine (EM) residency Method: This was a retrospective, cross-sectional study. A multidisciplinary...
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doaj-b20d9f0cc20e4addb3aca73c728b5c642020-11-25T00:36:58ZengElsevierAfrican Journal of Emergency Medicine2211-419X2019-12-0194202206The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approachRockefeller A. Oteng0Daniel Osei-Kwame1Maysel Stella E. Forson-Adae2Kwame Ekremet3Hussein Yakubu4Bernard Arhin5Ronald F. Maio6Department of Emergency Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, Michigan 48109, USA; Emergency Medicine Directorate, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, Ghana; Corresponding author at: Department of Emergency Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA.Emergency Medicine Directorate, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, GhanaEmergency Medicine Directorate, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, GhanaEmergency Medicine Directorate, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, GhanaEmergency Medicine Directorate, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, GhanaResearch and Development Unit, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, GhanaDepartment of Emergency Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, Michigan 48109, USAIntroduction: The purpose of the study was to determine the preventable trauma-related death rate (PDR) at Komfo Anokye Teaching Hospital in Kumasi, Ghana three years after initiation of an Emergency Medicine (EM) residency Method: This was a retrospective, cross-sectional study. A multidisciplinary panel of physicians completed a structured implicit review of clinical data for trauma patients who died during the period 2011 to 2012. The panel judged the preventability of each death and the nature of inappropriate care. Categories were definitely preventable (DP), possibly preventable (PP), and not preventable (NP). Results: 1) The total number of cases was forty-five; 36 cases had adequate data for review. Subjects were predominately male; road traffic injury (RTI) was the leading mechanism of injury. Four cases (11.1%) were DP, 14 cases (38.9%) were PP and 18 (50%) were NP. Hemorrhage was the leading cause of death (39%). Among DP/PP deaths there were 37 instances of inappropriate care. Delay in surgical intervention was the predominate event (50%). 2) The PDR for this study was 50% (0.95 CI, 33.7%–66.3%) Conclusion: Fifty percent of trauma deaths were DP/PP. Multiple episodes of varying types of inappropriate care occurred. More efficient surgical evaluation and appropriate treatment of hemorrhage could reduce trauma morality. Large amounts of missing and incomplete clinical data suggest considerable selection bias. A major implication of this study is the importance of having a robust, prospective trauma registry to collect clinical information to increase the number of cases for review. Keywords: Emergency medicine Ghana, Trauma care, Tertiary care Ghana, Structured panel review, Trauma-related deathhttp://www.sciencedirect.com/science/article/pii/S2211419X19301454 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rockefeller A. Oteng Daniel Osei-Kwame Maysel Stella E. Forson-Adae Kwame Ekremet Hussein Yakubu Bernard Arhin Ronald F. Maio |
spellingShingle |
Rockefeller A. Oteng Daniel Osei-Kwame Maysel Stella E. Forson-Adae Kwame Ekremet Hussein Yakubu Bernard Arhin Ronald F. Maio The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approach African Journal of Emergency Medicine |
author_facet |
Rockefeller A. Oteng Daniel Osei-Kwame Maysel Stella E. Forson-Adae Kwame Ekremet Hussein Yakubu Bernard Arhin Ronald F. Maio |
author_sort |
Rockefeller A. Oteng |
title |
The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approach |
title_short |
The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approach |
title_full |
The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approach |
title_fullStr |
The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approach |
title_full_unstemmed |
The preventability of trauma-related death at a tertiary hospital in Ghana: a multidisciplinary panel review approach |
title_sort |
preventability of trauma-related death at a tertiary hospital in ghana: a multidisciplinary panel review approach |
publisher |
Elsevier |
series |
African Journal of Emergency Medicine |
issn |
2211-419X |
publishDate |
2019-12-01 |
description |
Introduction: The purpose of the study was to determine the preventable trauma-related death rate (PDR) at Komfo Anokye Teaching Hospital in Kumasi, Ghana three years after initiation of an Emergency Medicine (EM) residency Method: This was a retrospective, cross-sectional study. A multidisciplinary panel of physicians completed a structured implicit review of clinical data for trauma patients who died during the period 2011 to 2012. The panel judged the preventability of each death and the nature of inappropriate care. Categories were definitely preventable (DP), possibly preventable (PP), and not preventable (NP). Results: 1) The total number of cases was forty-five; 36 cases had adequate data for review. Subjects were predominately male; road traffic injury (RTI) was the leading mechanism of injury. Four cases (11.1%) were DP, 14 cases (38.9%) were PP and 18 (50%) were NP. Hemorrhage was the leading cause of death (39%). Among DP/PP deaths there were 37 instances of inappropriate care. Delay in surgical intervention was the predominate event (50%). 2) The PDR for this study was 50% (0.95 CI, 33.7%–66.3%) Conclusion: Fifty percent of trauma deaths were DP/PP. Multiple episodes of varying types of inappropriate care occurred. More efficient surgical evaluation and appropriate treatment of hemorrhage could reduce trauma morality. Large amounts of missing and incomplete clinical data suggest considerable selection bias. A major implication of this study is the importance of having a robust, prospective trauma registry to collect clinical information to increase the number of cases for review. Keywords: Emergency medicine Ghana, Trauma care, Tertiary care Ghana, Structured panel review, Trauma-related death |
url |
http://www.sciencedirect.com/science/article/pii/S2211419X19301454 |
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