Description
- Abstract:
- Abstract of Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program by Peter Mattson, Degree ScM., Brown University, May 2020. Introduction: Musculoskeletal injuries (MSI) comprise a large portion of the trauma burden in low- and middle-income countries (LMICs). Rwanda recently launched its first emergency medicine training program (EMTP) at the University Teaching Hospital-Kigali (UTH-K), which may help to treat such injuries, yet no current epidemiological data is available on MSI in Rwanda. Methods: This pre-post study was conducted during two data collection periods at the UTH-K from November 2012 to July 2016. Data collection for MSI is limited and thus is specific to fractures. All patients with open, closed, or mixed fractures were included, hereafter referred to as MSI. Gathered information included demographics and outcomes including death, traumatic complications, and length of hospital stay, before and after the implementation of the EMTP. Results: Data from 3,609 patients was collected. Of those records, 691 patients were treated for fractures; 674 of these patients had sufficient EMTP data measured for inclusion in the analysis of results (279 from pre-EMTP and 375 from post-EMTP). Patient demographics demonstrate that a majority of MSI cases are male (71.6% male vs. 28.4% female) and young (64.3% below 35 years of age). Among mechanisms of injury, major causes include road traffic accidents (48.1%), falls (34.2%), and assault (6.0%). There was also an observed association between EMTP and trends of the three primary outcomes: a reduction of death in the ED from those with MSI by 89.9%, from 2.51% to 0.25% (p=0.0077), a reduction in traumatic complications for MSI patients by 71.7%, from 3.58% to 1.01% (p=0.0211), and a reduction in duration of stay in the ED among those with MSI by 52.7% or 2.81 days on average, from 5.33 to 2.52 days (p=0.0437). Conclusion: This study reveals the current epidemiology of MSI morbidity and mortality for a major Rwandan teaching hospital and the potential impacts of emergency medicine training implementation among those with MSI. Residency training programs such as EMTP appear capable of reducing mortality, complications, and ED length of stay among those with MSI caused by fractures. Such findings underscore the efficacy and importance of investments toward educating the next generation of health professionals to combat prevalent MSI within their communities.
- Notes:
- Thesis (Sc. M.)--Brown University, 2020
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Citation
Mattson, Peter Charles,
"Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program"
(2020).
Biology and Medicine Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:1129396/
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Biology and Medicine Theses and Dissertations
Theses and Dissertations for the Biology and Medicine department....