Mechanism of injury and disposition of severe polytrauma patients at Kalafong Hospital 2018/2019

Abstract

Background: The most common mechanisms of injury (MOI) for trauma patients in South Africa (SA) are transport-related and interpersonal violence. South Africa is rated among the highest in the world with regard to mortality from injuries sustained, yet many tertiary public hospitals do not have dedicated trauma teams. The aim of this study was to observe the MOI and disposition of severe polytrauma patients presenting to Kalafong Provincial Tertiary Hospital (KPTH) emergency department (ED). A secondary aim was to observe associations between the MOI, severity of injuries, and patient outcome.

Methods: Retrospective descriptive data were collected on all severe polytrauma patients who presented at KPTH ED from 01 July 2018 to 31 December 2019.

Results: Most severe polytrauma patients were males (62%). Motor vehicle accidents (MVAs) were the most prevalent mechanism, which accounted for 28% of MOI. Patients involved in pedestrian vehicle accidents (PVAs) were most severely injured. Most patients were admitted to the intensive care unit (ICU) (36%) or high care unit (HCU) (26%). The waiting time for ICU admissions ranged between 6.4 and 7.7 h. Fourteen per cent of patients demised in the ED before admission.

Conclusion: While MVA was the predominant MOI for severe polytrauma patients presenting to KPTH ED, patients involved in PVAs were most severely injured. The majority of severe polytrauma patients were admitted to ICU.

Contribution: This study contributes to the limited literature on the important topic of severe polytrauma in Gauteng, SA. It may influence staffing decisions and motivate for province-wide trauma database collection.