Aim: To describe the profile of severe trauma adults who died in polyvalent intensive care unit at University Hospital of Brazzaville. Materials and methods: It was a retrospective, cross-sectional study carried out in polyvalent intensive care unit of University Hospital of Brazzaville, during 30 months period. We included all severe trauma who died, aged 18 years or over patients regardless of age or sex and treated for at least one hour in intensive care. Epidemiological, clinical and therapeutic parameters were recorded and analyzed with Excel 2016 for Windows. Results: During the study period, 35 deaths out of 90 severe trauma patients were recorded, i.e. a lethality rate of 38.8%. The mean age was 42.4±18.6 years (sex ratio=7.5). Admissions were primary in 58.8%. Road traffic collisions (RTC, 73.5%) were the most common mechanism of injury involved. In intensive care, 82.4% of patients presented with severe trauma brain injury (TBI), of which 50.0% was isolated. Respiratory (47.1%) and hemodynamic (17.6%) distress were observed. Pickup and transport of trauma victims were not medical. Oxygen therapy (91.2%), blood transfusion (23.5%), use of vasopressor amines (47.1%) and osmotherapy (23.5%) were necessary. The patients were intubated and ventilated then sedated in 64.7%. Surgical management concerned 20.6% and was dominated by neurosurgical indications. Neurological distress (61.8%) was the main cause of death. Conclusion: The lethality rate of severe trauma patients was high, affecting young males, victims of both RTC and severe TBI. This confirms the need to promote collaboration and communication between hospital structures, to set up pre-hospital care structures, to improve the technical platform and to train staff involved in their care.
| Published in | International Journal of Anesthesia and Clinical Medicine (Volume 9, Issue 2) |
| DOI | 10.11648/j.ijacm.20210902.15 |
| Page(s) | 41-48 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Mortality, Severe Trauma, Polyvalent Intensive Care Unit, Brazzaville
| [1] | World Health Organization (WHO). Injuries and violence. https://www.who.int/topics/injuries/about/fr/ accessed January 15, 2021. |
| [2] | Alingrin J, Tezier M, Hammad E, et al. Traumatisés graves en réanimation et choc septique: facteurs de risque, incidence et mortalité. [severe trauma in intensive care and septic shock: risk factors, incidence and mortality]. Anesthésie & Réanimation 2015; 1 (1): A8-9. |
| [3] | Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet 1997; 349 (9064): 1498–504. |
| [4] | Diemer HSC, Mapouka PAI, Tchebemou-Ngueya SJ et de Dieu Tékpa BJ. Les aspects épidémiologiques de la mortalité en orthopédie traumatologie de l’hôpital communautaire. [Epidemiological aspects of trauma orthopedic mortality in the community hospital]. Journal Européen des Urgences et de Réanimation 2020; 32: 4-8. https://doi.org/10.1016/j.jeurea.2019.10.002. |
| [5] | Yeguiayan JM et Freysz M. Réseau de prise en charge du traumatisé grave. [Severe trauma care networt]. Urgences 2009. |
| [6] | Murat J. E, Huten N. Polytraumatisés. [Poly trauma]. Encycl Méd Chir Urg 1995; 24-101-D10. |
| [7] | Poirier M, Hammad E, Antonini F, et al. Parcours intra hospitalier et délais de prise en charge du patient traumatisé grave. [Intra-hospital course and delays management of severe trauma patient]. Annales françaises d’Anesthésie et Réanimation 2014; 33 Suppl 2: A371-2. https://doi.org/10.1016/j.annfar.2014.07.624. |
| [8] | Farzaneh M, Mohsen A. The quality of pre-hospital circulatory management in patients with multiple trauma referred to the trauma center of shahidbeheshti. Arch Trauma Res 2014; 3: e17150. |
| [9] | Hunga MJP, Amisi BE, Nsumbu NT, et al (2014). Prise en charge des traumatisés sévères en réanimation des cliniques universitaires de Kinshasa: état des lieux. [Management of severe trauma in intensive care at university clinics in Kinshasa: inventory]. Rev Afr Anesth Med Urg 2014. |
| [10] | Otiobanda GF, Monkessa CMME, Elombila M, et al. Epidemiological, clinical aspects and outcomes of polytrauma in polyvalent intensive care unit at University Hospital of Brazzaville, Republic of Congo. MIR 2020; 29 (3): 173-82. https://doi.org/10.37051/mir-00027. |
| [11] | Schaal JV et Raux M. Triages et scores de gravité. [Sorting and severity scores]. Conférence MAPAR 2013: 133-44. |
| [12] | Tchaou BA, Assouto P, Hodonou MA, et al. Management of polytrauma in the University Hospital of Parakou (Benin). Rev Afr Anesth Med Urg 2013; 17 (3). |
| [13] | Essola L, Ngondé Monsu LO, Soami V, Ngomas JF, Sima Zué. Mortalité en Unité de Soins Intensifs du Centre Hospitalier Universitaire de Libreville: causes et facteurs de risque. [Mortality in the Intensive Care Unit of the Centre Hospitalier Universitaire de Libreville: causes and risck factors]. Rev. Afr. Anesthésiol. Med. Urgence 2017; 22 (1): 41-6. |
| [14] | Chalya PL, Gilyoma JM, Dass RM, et al. Trauma admissions to the Intensive care unit at a reference hospital in Northwestern Tanzania. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2011; 19 (61): 3-7 http://www.sjtrem.com/content/19/1/61. |
| [15] | Assenouwe S, Tomta K, Mouzou T, et al. Prise en charge des polytraumatisés en réanimation au CHU Sylvanus Olympio de Lomé. [Management of polytrauma patients in intensive care units at the Sylvanus Olympio University Hospital in Lomé (Togo)]. Rev Afr Anesth Med Urg 2015. |
| [16] | Hadžan Konjo, Emira Svraka, Demil Omerović, et al. Incidence of hospital mortality in polytrauma patients in a tertiary center in Bosnia and Herzegovina. Journal of Health Sciences 2016; 6 (1): 67-71. |
| [17] | Yaqini K, Maanaoui Y, Elatiqi I, et al. Évaluation de la prise en charge des traumatisés graves suite à une chute d’un lieu élevé (à propos de 104 cas). [Assessment of the management of severe trauma following a fall from a high place (about 104 cases)]. SRLF 2015. Réanimation 24: S209-S213DOI 10.1007/s13546-014-0988-4EP063. |
| [18] | Najall Pouth C, Bita Fouda AA, Beyiha G, et al. Facteurs pronostiques des traumatisés graves de la route admis au service de réanimation de l’hôpital Laquintinie de Douala. [Prognosis factors in patients with severe trauma admitted in intensive care at Laquintinie hospital in Douala]. Rev Afr Anesth Med Urg 2013; 17 (3). |
| [19] | Nsumbi T et Nsiala J. Mortalité et facteurs pronostiques du traumatisme grave dans la ville-province de Kinshasa. [Mortality and prognostic factors of severe trauma in the city-province of Kinshasa]. Ann. Afr. Med. 2016; 9 (3): 2353. |
| [20] | Adenekan AT et Faponle AF. Trauma Admissions to the ICU of a Tertiary Hospital in a Low Resource Setting. African Journal of Anaesthesia and Intensive Care 2009; 9 (2): 5-7. |
| [21] | Theodorou D, Toutouzas K, Drimousis P, et al. Emergency room management of trauma patients in Greece: preliminary report of a national study. Resuscitation 2009; 80: 350-3. |
| [22] | Richardson JD, Franklin G, Santos A, et al. Effective triage can ameliorate the deleterious effects of delayed transfer of trauma patients from the emergency department to the ICU. J Am Coll Surg 2009; 208: 671-8. |
| [23] | Bernhard M, Becker TK, Nowe T, et al. Introduction of a treatment algorithm can improve the early management of emergency patients in the resuscitation room. Resuscitation 2007; 73: 362-73. |
| [24] | Charpentier C, Orly K, Garric J, et al. Epidémiologie des polytraumatismes: quels changements en 20 ans? [Epidemiology of poly trauma: what changes in 20 years?]. Anesthésie & Réanimation 2015; 1: Suppl 1, Page A24. |
| [25] | Pfeifer R, Tarkin IS, Rocos B et Pape HC. Patterns of mortality and causes of death polytrauma patients – Has anything changed? Injury, Int. J. Care Injured 2009; 40 (9): 907-11. doi: 10.1016/j.injury.2009.05.006. |
| [26] | Idri S, Gauss T, Mortelecque-Baglioni R, et al. Retour d’expérience sur une procédure d’urgence transfusionnelle pour les patients traumatisés graves à l’hôpital Beaujon. [Feedback on a procedure emergency transfusion for severe trauma patients at Beaujon Hospital]. Transfusion Clinique et Biologique 2015; 22 (4): 203. https://doi.org/10.1016/j.tracli.2015.06.258. |
| [27] | Duranteau J, Asehnoune K, Pierre S, et al. Recommandations sur la réanimation du choc hémorragique. [Guidelines on the treatment of hemorrhagic shock]. Anesthésie & Réanimation 2015; 1 (1): 62-74. |
| [28] | Rossaint R, Bouillon B, Vladimir Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Critical Care 2016; 20 (1): 100. DOI 10.1186/s13054-016-1265-x. |
| [29] | Yeguiayan JM, Garrigue D, Binquet C, et al. Prise en charge actuelle du traumatisé grave en France: premier bilan de l’étude FIRST (French Intensive care Recorded in Severe Trauma) [Current support for severe blunt trauma patients in France: initial assessment of the FIRST study (French Intensive care Recorded in Severe Trauma)]. Annales Françaises de Médecine d'Urgence 2012; 2 (3): 156-63. |
| [30] | Servià L, Badia M, Baeza I, et al. Time spent in the emergency department and mortality rates in severely injured patients admitted to the intensive care unit: An observational study. Journal of Critical Care 2012; 27: 58-65. |
| [31] | Obame R, Sagbo Ada LV, Nzé Obiang PK, et al. Aspects épidémiologiques, thérapeutiques et évolutifs des polytraumatisés admis en réanimation du centre hospitalier universitaire d’Owendo. [Epidemiology, clinical features and outcome of the multi-trauma patient in the ICU of theHospital Teaching University of Owendo]. Health Sci Dis 2019; 20: 86-9 [Disponible gratuitement sur www.hsd-fmsb.org]. |
| [32] | Evans J, Wessem D. Epidemiology of traumatic deaths: comprehensive population-based assessment. Departement of traumatology, division of surgery, john hunter hospital and university of newcastle Australia. World J Surg 2010; 34: 1720-1. |
| [33] | Zue AS, Benamar B, Ngaka D, Mbini J et Nzoghe J. Pathologie traumatique et réanimation en milieu africain. [Trauma pathology and intensive care unit in african environment: experience of the libreville hospital center]. Médecine D'Afrique Noire 1998; 45 (8/9): 535-7. |
| [34] | Abubakar AS, Ojo EO, El-Nafaty AU et Edomwonyi NP. An audit of one-year intensive care practice in a developing country. The Internet Journal of Anesthesiology 2008; 18: 2. |
| [35] | Probst C, Pape HC, Hildebrand F, et al. 30 years of polytrauma care: An analysis of the change in strategies and results of 4849 cases treated at a single institution. Injury 2009; 40 (1): 77-83. |
| [36] | Davis D. P. Early ventilation in traumatic brain injury. Resuscitation 2008; 76: 333- 40. |
| [37] | Ozoilo KN, Nwadiaro HC, Iya D, et al. The Conundrum of Polytrauma on the Jos Plateau. West Afr J Med 2012; 31: 52-7. |
| [38] | Diouf E, Beye MD, Diop Ndoye M, et al. Evaluation de la prise en charge des polytraumatisés au CHU Le Dantec de Dakar. [Assessment of the management of polytrauma patients at le Dantec Hospital]. Dakar. Med. 2003; 48: 117-22. |
| [39] | Gomez de Sergura Nieva JL, Boncompte MM, Sucunza AE, et al. Comparison of mortality due to severe multiple trauma in two comprehensive models of emergency care: Atlantic Pyrenees (France) and Navarra (Spain). J Emerg Med 2009; 37: 189-200. |
APA Style
Christ Mayick Mpoy Emy Monkessa, Marie Elombila, Gilles Niengo Outsouta, Peggy Dahlia Gallou Leyono-Mawandza, Marina Aurole Bokoba-Nde Ngala, et al. (2021). Mortality of Severe Trauma Adults Patients in Polyvalent Intensive Care Unit at University Hospital of Brazzaville, Republic of Congo. International Journal of Anesthesia and Clinical Medicine, 9(2), 41-48. https://doi.org/10.11648/j.ijacm.20210902.15
ACS Style
Christ Mayick Mpoy Emy Monkessa; Marie Elombila; Gilles Niengo Outsouta; Peggy Dahlia Gallou Leyono-Mawandza; Marina Aurole Bokoba-Nde Ngala, et al. Mortality of Severe Trauma Adults Patients in Polyvalent Intensive Care Unit at University Hospital of Brazzaville, Republic of Congo. Int. J. Anesth. Clin. Med. 2021, 9(2), 41-48. doi: 10.11648/j.ijacm.20210902.15
AMA Style
Christ Mayick Mpoy Emy Monkessa, Marie Elombila, Gilles Niengo Outsouta, Peggy Dahlia Gallou Leyono-Mawandza, Marina Aurole Bokoba-Nde Ngala, et al. Mortality of Severe Trauma Adults Patients in Polyvalent Intensive Care Unit at University Hospital of Brazzaville, Republic of Congo. Int J Anesth Clin Med. 2021;9(2):41-48. doi: 10.11648/j.ijacm.20210902.15
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ijacm.20210902.15,
author = {Christ Mayick Mpoy Emy Monkessa and Marie Elombila and Gilles Niengo Outsouta and Peggy Dahlia Gallou Leyono-Mawandza and Marina Aurole Bokoba-Nde Ngala and Giresse Bienvenu Tsouassa Wa Ngono and Hugues Brieux Ekouele-Mbaki and Gilbert Fabrice Otiobanda},
title = {Mortality of Severe Trauma Adults Patients in Polyvalent Intensive Care Unit at University Hospital of Brazzaville, Republic of Congo},
journal = {International Journal of Anesthesia and Clinical Medicine},
volume = {9},
number = {2},
pages = {41-48},
doi = {10.11648/j.ijacm.20210902.15},
url = {https://doi.org/10.11648/j.ijacm.20210902.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20210902.15},
abstract = {Aim: To describe the profile of severe trauma adults who died in polyvalent intensive care unit at University Hospital of Brazzaville. Materials and methods: It was a retrospective, cross-sectional study carried out in polyvalent intensive care unit of University Hospital of Brazzaville, during 30 months period. We included all severe trauma who died, aged 18 years or over patients regardless of age or sex and treated for at least one hour in intensive care. Epidemiological, clinical and therapeutic parameters were recorded and analyzed with Excel 2016 for Windows. Results: During the study period, 35 deaths out of 90 severe trauma patients were recorded, i.e. a lethality rate of 38.8%. The mean age was 42.4±18.6 years (sex ratio=7.5). Admissions were primary in 58.8%. Road traffic collisions (RTC, 73.5%) were the most common mechanism of injury involved. In intensive care, 82.4% of patients presented with severe trauma brain injury (TBI), of which 50.0% was isolated. Respiratory (47.1%) and hemodynamic (17.6%) distress were observed. Pickup and transport of trauma victims were not medical. Oxygen therapy (91.2%), blood transfusion (23.5%), use of vasopressor amines (47.1%) and osmotherapy (23.5%) were necessary. The patients were intubated and ventilated then sedated in 64.7%. Surgical management concerned 20.6% and was dominated by neurosurgical indications. Neurological distress (61.8%) was the main cause of death. Conclusion: The lethality rate of severe trauma patients was high, affecting young males, victims of both RTC and severe TBI. This confirms the need to promote collaboration and communication between hospital structures, to set up pre-hospital care structures, to improve the technical platform and to train staff involved in their care.},
year = {2021}
}
TY - JOUR T1 - Mortality of Severe Trauma Adults Patients in Polyvalent Intensive Care Unit at University Hospital of Brazzaville, Republic of Congo AU - Christ Mayick Mpoy Emy Monkessa AU - Marie Elombila AU - Gilles Niengo Outsouta AU - Peggy Dahlia Gallou Leyono-Mawandza AU - Marina Aurole Bokoba-Nde Ngala AU - Giresse Bienvenu Tsouassa Wa Ngono AU - Hugues Brieux Ekouele-Mbaki AU - Gilbert Fabrice Otiobanda Y1 - 2021/11/05 PY - 2021 N1 - https://doi.org/10.11648/j.ijacm.20210902.15 DO - 10.11648/j.ijacm.20210902.15 T2 - International Journal of Anesthesia and Clinical Medicine JF - International Journal of Anesthesia and Clinical Medicine JO - International Journal of Anesthesia and Clinical Medicine SP - 41 EP - 48 PB - Science Publishing Group SN - 2997-2698 UR - https://doi.org/10.11648/j.ijacm.20210902.15 AB - Aim: To describe the profile of severe trauma adults who died in polyvalent intensive care unit at University Hospital of Brazzaville. Materials and methods: It was a retrospective, cross-sectional study carried out in polyvalent intensive care unit of University Hospital of Brazzaville, during 30 months period. We included all severe trauma who died, aged 18 years or over patients regardless of age or sex and treated for at least one hour in intensive care. Epidemiological, clinical and therapeutic parameters were recorded and analyzed with Excel 2016 for Windows. Results: During the study period, 35 deaths out of 90 severe trauma patients were recorded, i.e. a lethality rate of 38.8%. The mean age was 42.4±18.6 years (sex ratio=7.5). Admissions were primary in 58.8%. Road traffic collisions (RTC, 73.5%) were the most common mechanism of injury involved. In intensive care, 82.4% of patients presented with severe trauma brain injury (TBI), of which 50.0% was isolated. Respiratory (47.1%) and hemodynamic (17.6%) distress were observed. Pickup and transport of trauma victims were not medical. Oxygen therapy (91.2%), blood transfusion (23.5%), use of vasopressor amines (47.1%) and osmotherapy (23.5%) were necessary. The patients were intubated and ventilated then sedated in 64.7%. Surgical management concerned 20.6% and was dominated by neurosurgical indications. Neurological distress (61.8%) was the main cause of death. Conclusion: The lethality rate of severe trauma patients was high, affecting young males, victims of both RTC and severe TBI. This confirms the need to promote collaboration and communication between hospital structures, to set up pre-hospital care structures, to improve the technical platform and to train staff involved in their care. VL - 9 IS - 2 ER -
Information
Email: