Trauma care and referral patterns in Rwanda: Implications for trauma system development

dc.contributor.authorNtakiyiruta, Georges., etal
dc.date.accessioned2019-01-31T11:24:53Z
dc.date.available2019-01-31T11:24:53Z
dc.date.issued2015-11-09
dc.descriptionSee discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/292078277en_US
dc.description.abstractBackground: Trauma remains a leading cause of death worldwide. The development of trauma systems in low-resource settings may be of benefit. The objective of this study was to describe operative procedures performed for trauma at a tertiary care facility in Kigali, Rwanda, and to evaluate geographical variations and referral patterns of trauma care. Methods: We retrospectively reviewed all prospectively collected operative cases performed at the largest referral hospital in Rwanda, the Centre Hospitalier Universitaire de Kigali (CHUK), between June 1 and Dec. 1, 2011, for injury-related diagnoses. We used the Pearson χ² and Fisher exact tests to compare cases arising from within Kigali to those transferred from other provinces. Geospatial analyses were also performed to further elucidate transfer patterns. Results: Over the 6-month study period, 2758 surgical interventions were performed at the CHUK. Of these, 653 (23.7%) were for trauma. Most patients resided outside of Kigali city, with 337 (58.0%) patients transferred from other provinces and 244 (42.0%) from within Kigali. Most trauma procedures were orthopedic (489 [84.2%]), although general surgery procedures represented a higher proportion of trauma surgeries in patients from other provinces than in patients from within Kigali (28 of 337 [8.3%] v. 10 of 244 [4.1%]). Conclusion: To our knowledge, this is the first study to highlight geographical variations in access to trauma care in a low-income country and the first description of trauma procedures at a referral centre in Rwanda. Future efforts should focus on maturing prehospital and interfacility transport systems, strengthening district hospitals and further supporting referral institutions.en_US
dc.identifier.otherDOI: 10.1503/cjs.008115
dc.identifier.urihttp://hdl.handle.net/20.500.12306/1537
dc.language.isoenen_US
dc.publisherCanadian journal of surgeryen_US
dc.subjectTrauma careen_US
dc.subjectReferral patternsen_US
dc.subjectRwandaen_US
dc.subjectSystem developmenten_US
dc.titleTrauma care and referral patterns in Rwanda: Implications for trauma system developmenten_US
dc.typeArticleen_US
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