The association between hospital arrival time, transport method, prehospital time intervals, and in-hospital mortality in trauma patients presenting to Khayelitsha Hospital, Cape Town
Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Introduction: Trauma is a leading cause of unnatural death and disability in South Africa. The aim of the study
was to determine whether method of transport, hospital arrival time or prehospital transport time intervals were
associated with in-hospital mortality among trauma patients presenting to Khayelitsha Hospital, a district-level
hospital on the outskirts of Cape Town, South Africa.
Methods: The Khayelitsha Hospital Emergency Centre database was retrospectively analysed for trauma-related
patients presenting to the resuscitation area between 1 November 2014 and 30 April 2015. Missing data and
additional variables were collected by means of a chart review. Eligible patients’ folders were scrutinised for
hospital arrival time, transport time intervals, transport method and in-hospital mortality. Descriptive statistics
were presented for all variables. Categorical data were analysed using the Fisher’s Exact test and Chi-square,
continuous data by logistic regression and the Mann Whitney test. A confidence interval of 95% was used to
describe variance and a p-value of <0.05 was deemed significant.
Results: The majority of patients were 19–44 year old males (n=427, 80.3%) and penetrating trauma the most
frequent mechanism of injury (n=343, 64.5%). In total, 258 (48.5%) patients arrived with their own transport,
254 (47.7%) by ambulance and 20 (3.8%) by the police service. The arrival of trauma patients peaked during the
weekend, and was especially noticeable between midnight and six a.m. In-hospital mortality (n=18, 3.4%) was
not significantly affected by transport method (p=0.26), hospital arrival time (p=0.22) or prehospital
transport time intervals (all p-values >0.09).
Discussion: Method of transport, hospital arrival time and prehospital transport time intervals did not have a
substantially measurable effect on in-hospital mortality. More studies with larger samples are suggested due to
the small event rate.
Description
CITATION: Moller, A., et al. 2018. The association between hospital arrival time, transport method, prehospital time intervals, and in-hospital mortality in trauma patients presenting to Khayelitsha Hospital, Cape Town. African Journal of Emergency Medicine, 8(3):89-94, doi:10.1016/j.afjem.2018.01.001.
The original publication is available at https://www.sciencedirect.com
The original publication is available at https://www.sciencedirect.com
Keywords
Trauma patients, Wounds and injuries -- Patients -- Mortality -- Khayelitsha (Cape Town, South Africa), Ambulatory care -- Khayelitsha (Cape Town, South Africa), Public hospitals -- Khayelitsha (Cape Town, South Africa), Emergency medicine -- Khayelitsha (Cape Town, South Africa)
Citation
Moller, A., et al. 2018. The association between hospital arrival time, transport method, prehospital time intervals, and in-hospital mortality in trauma patients presenting to Khayelitsha Hospital, Cape Town. African Journal of Emergency Medicine, 8(3):89-94, doi:10.1016/j.afjem.2018.01.001