Trauma in rural Kenya.

Abstract

Trauma in Africa is an increasingly significant problem. The aims of this study were to document the epidemiology and clinical management of trauma in a rural Kenyan hospital and from this to highlight important areas for the medical training of doctors managing trauma in similar situations. Prospective audit of 202 consecutive trauma patients admitted to Kijabe Hospital. The mean patient age was 31, 77% were males. The median Injury Severity Score (ISS) was nine. The median distance to hospital was 60 km, with a 9 h delay in presentation. Injury mechanisms included road traffic accidents 52%, fall 22%, assaults 13% and burns 6%. The main injuries were limb fractures, soft tissue injuries, head injury and haemo/pneumothorax. Common interventions included fracture management, wound debridement, chest drain insertion, blood transfusion and skin grafting. The overall mortality rate was 3.5%. With appropriate resources and training, good trauma outcomes are possible. The importance of access to hospital care and orthopaedic training are highlighted.