Erica Ludi Presents Study at PTS Annual Congress
PGY-2 general surgery resident Erica Ludi, MD, presented "Trauma Surveillance and Epidemiology in Haiti: A Pilot Study" at the 2017 Panamerican Congress of Trauma, Critical Care & Emergency Surgery in Mexico City, on November 30, 2017. The Congress was sponsored by the Panamerican Trauma Society.
Dr. Ludi was first author, and PGY-2 Martha-Conley Ingram, MD, was second. Their Emory Surgery faculty co-authors included Christopher Dente, MD, John Sweeney, MD, and senior author Jahnavi Srinivasan, MD.
Haiti's mortality rate due to injuries is estimated to be twice that of the United States. However, trauma statistics reporting has not been standardized in the country. To exemplify the value of quantifying the country's burden of trauma-related disease, Dr. Ludi and the project team piloted a trauma surveillance logbook at four Haitian hospitals in different regions.
The team developed a 17-item registry logbook and an eight-to-ten minute training presentation on iPad for emergency department (ED) staff at the four hospitals. Data collection took place prospectively over four weeks. Upon completion, the logbook was compared to ED registries, and data was collected retrospectively for unrecorded, qualifying patients.
The data analysis included 1169 patients, 68.1 percent of whom were male, with an average age of 27.3 years. The majority of injuries were seen in patients aged 15-29. The highest number of patients presented on Fridays, and the largest volume of patients per hour occurred during the afternoon nursing shift (1:00-7:00 p.m., or 2:00-8:00 p.m.). The majority of patients arrived alert (94.7 percent), within four hours of injury (77.9 percent), and by motorcycle (35 percent).
The three most common injury mechanisms were traffic accidents (37.7 percent), falls (17.0 percent), or knife/cut wounds (12.6 percent). The upper extremities (33.6 percent), lower extremities (30.8 percent), and the head/neck (26.7 percent) were the most frequently injured body regions. 90.1 percent of patients received treatment in the ED, with the majority receiving minor and medical care (46.9 percent). Discharge status was recorded for 1009 patients (86.3 percent), with 54.9 percent simply being treated and discharged.
For Dr. Ludi and her co-authors, the study represented the value of capturing such data in Haiti so that informed decisions regarding resource allocation and injury prevention programs can be established.