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Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program.

Publication ,  Journal Article
Mattson, P; Nteziryayo, E; Aluisio, AR; Henry, M; Rosenberg, N; Mutabazi, ZA; Nyinawankusi, JD; Byiringiro, JC; Levine, AC; Karim, N
Published in: West J Emerg Med
October 14, 2019

INTRODUCTION: Musculoskeletal injuries (MSI) comprise a large portion of the trauma burden in low- and middle-income countries (LMIC). 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: We conducted this pre-post study 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. We included all patients with open, closed, or mixed fractures, 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: We collected data from 3609 patients. Of those records, 691 patients were treated for fractures, and 674 of them 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 included 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 emergency department (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 EM 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 in educating the next generation of health professionals to combat prevalent MSI within their communities.

Duke Scholars

Published In

West J Emerg Med

DOI

EISSN

1936-9018

Publication Date

October 14, 2019

Volume

20

Issue

6

Start / End Page

857 / 864

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Rwanda
  • Male
  • Length of Stay
  • Internship and Residency
  • Humans
  • Hospitals, Teaching
  • Fractures, Bone
  • Female
  • Emergency Service, Hospital
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mattson, P., Nteziryayo, E., Aluisio, A. R., Henry, M., Rosenberg, N., Mutabazi, Z. A., … Karim, N. (2019). Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program. West J Emerg Med, 20(6), 857–864. https://doi.org/10.5811/westjem.2019.7.41448
Mattson, Peter, Ezechiel Nteziryayo, Adam R. Aluisio, Michael Henry, Noah Rosenberg, Zeta A. Mutabazi, Jeanne D’Arc Nyinawankusi, Jean Claude Byiringiro, Adam C. Levine, and Naz Karim. “Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program.West J Emerg Med 20, no. 6 (October 14, 2019): 857–64. https://doi.org/10.5811/westjem.2019.7.41448.
Mattson P, Nteziryayo E, Aluisio AR, Henry M, Rosenberg N, Mutabazi ZA, et al. Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program. West J Emerg Med. 2019 Oct 14;20(6):857–64.
Mattson, Peter, et al. “Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program.West J Emerg Med, vol. 20, no. 6, Oct. 2019, pp. 857–64. Pubmed, doi:10.5811/westjem.2019.7.41448.
Mattson P, Nteziryayo E, Aluisio AR, Henry M, Rosenberg N, Mutabazi ZA, Nyinawankusi JD, Byiringiro JC, Levine AC, Karim N. Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program. West J Emerg Med. 2019 Oct 14;20(6):857–864.

Published In

West J Emerg Med

DOI

EISSN

1936-9018

Publication Date

October 14, 2019

Volume

20

Issue

6

Start / End Page

857 / 864

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Rwanda
  • Male
  • Length of Stay
  • Internship and Residency
  • Humans
  • Hospitals, Teaching
  • Fractures, Bone
  • Female
  • Emergency Service, Hospital