Is mechanism of injury associated with outcome in spinal trauma? An observational cohort study from Tanzania
Traumatic spinal injury (TSI) is a disease of significant global health burden, particularly in low and middle-income countries where road traffic-related trauma is increasing. This study compared the demographics, injury patterns, and outcomes of TSI caused by road traffic accidents (RTAs) to non-t...
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| creator | Ikwuegbuenyi, Chibuikem Anthony Woodfield, Julie Waterkeyn, François Zuckerman, Scott L Cheserem, Beverly Leidinger, Andreas Lazaro, Albert Shabani, Hamisi K Härtl, Roger Mangat, Halinder S |
| description | Traumatic spinal injury (TSI) is a disease of significant global health burden, particularly in low and middle-income countries where road traffic-related trauma is increasing. This study compared the demographics, injury patterns, and outcomes of TSI caused by road traffic accidents (RTAs) to non-traffic related TSI.
A retrospective analysis was conducted using a neurotrauma registry from the Muhimbili Orthopaedic Institute (MOI) in Tanzania, a national referral center for spinal injuries. Patient sociodemographic characteristics, injury level, and severity were compared across mechanisms of injury. Neurological improvement, neurological deterioration, and mortality were compared between those sustaining TSI through an RTA versus non-RTA, using univariable and multivariable analyses.
A total of 626 patients were included, of which 302 (48%) were RTA-related. The median age was 34 years, and 532 (85%) were male. RTAs had a lower male preponderance compared to non-RTA causes (238/302, 79% vs. 294/324, 91%, p |
| doi_str_mv | 10.1371/journal.pone.0306577 |
| format | Article |
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A retrospective analysis was conducted using a neurotrauma registry from the Muhimbili Orthopaedic Institute (MOI) in Tanzania, a national referral center for spinal injuries. Patient sociodemographic characteristics, injury level, and severity were compared across mechanisms of injury. Neurological improvement, neurological deterioration, and mortality were compared between those sustaining TSI through an RTA versus non-RTA, using univariable and multivariable analyses.
A total of 626 patients were included, of which 302 (48%) were RTA-related. The median age was 34 years, and 532 (85%) were male. RTAs had a lower male preponderance compared to non-RTA causes (238/302, 79% vs. 294/324, 91%, p<0.001) and a higher proportion of cervical injuries (144/302, 48% vs. 122/324, 38%, p<0.001). No significant differences between RTA and non-RTA mechanisms were found in injury severity, time to admission, length of hospital stay, surgical intervention, neurological outcomes, or in-hospital mortality. Improved neurological outcomes were associated with incomplete injuries (AIS B-D), while higher mortality rates were linked to cervical injuries and complete (AIS A) injuries.
Our study in urban Tanzania finds no significant differences in outcomes between spinal injuries from road traffic accidents (RTAs) and non-RTA causes, suggesting the need for equitable resource allocation in spine trauma programs. Highlighting the critical link between cervical injuries and increased mortality, our findings call for targeted interventions across all causes of traumatic spinal injuries (TSI). We advocate for a comprehensive trauma care system that merges efficient pre-hospital care, specialized treatment, and prevention measures, aiming to enhance outcomes and ensure equity in trauma care in low- and middle-income countries.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0306577</identifier><identifier>PMID: 39024312</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accidents ; Accidents, Traffic - statistics & numerical data ; Adolescent ; Adult ; Biology and Life Sciences ; Cohort analysis ; Comparative analysis ; Computer and Information Sciences ; Demographics ; Engineering and Technology ; Fatalities ; Female ; Fractures ; Global health ; Hospitals ; Humans ; Injuries ; Injury analysis ; Injury prevention ; Length of stay ; Male ; Males ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Motorcycles ; Observational studies ; Orthopedics ; Patients ; Pedestrians ; Public health ; Quality improvement ; Resource allocation ; Retrospective Studies ; Roads ; Sociodemographics ; Spinal cord injuries ; Spinal Injuries - epidemiology ; Spinal Injuries - mortality ; Spine ; Surgery ; Tanzania - epidemiology ; Traffic ; Traffic accidents ; Traffic accidents & safety ; Trauma ; Traumatic brain injury ; Vehicles ; World health ; Young Adult</subject><ispartof>PloS one, 2024-07, Vol.19 (7), p.e0306577</ispartof><rights>Copyright: © 2024 Ikwuegbuenyi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Ikwuegbuenyi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Ikwuegbuenyi et al 2024 Ikwuegbuenyi et al</rights><rights>2024 Ikwuegbuenyi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c572t-15e10e04cbff307899c864ceec73ea33808d2b9e6bc9ca4e60b27b53aa26d6fd3</cites><orcidid>0000-0003-3426-2001 ; 0000-0003-3646-7713 ; 0000-0002-0966-1062 ; 0000-0003-3645-500X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257230/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257230/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39024312$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ukachukwu, Alvan-Emeka K.</contributor><creatorcontrib>Ikwuegbuenyi, Chibuikem Anthony</creatorcontrib><creatorcontrib>Woodfield, Julie</creatorcontrib><creatorcontrib>Waterkeyn, François</creatorcontrib><creatorcontrib>Zuckerman, Scott L</creatorcontrib><creatorcontrib>Cheserem, Beverly</creatorcontrib><creatorcontrib>Leidinger, Andreas</creatorcontrib><creatorcontrib>Lazaro, Albert</creatorcontrib><creatorcontrib>Shabani, Hamisi K</creatorcontrib><creatorcontrib>Härtl, Roger</creatorcontrib><creatorcontrib>Mangat, Halinder S</creatorcontrib><title>Is mechanism of injury associated with outcome in spinal trauma? An observational cohort study from Tanzania</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Traumatic spinal injury (TSI) is a disease of significant global health burden, particularly in low and middle-income countries where road traffic-related trauma is increasing. This study compared the demographics, injury patterns, and outcomes of TSI caused by road traffic accidents (RTAs) to non-traffic related TSI.
A retrospective analysis was conducted using a neurotrauma registry from the Muhimbili Orthopaedic Institute (MOI) in Tanzania, a national referral center for spinal injuries. Patient sociodemographic characteristics, injury level, and severity were compared across mechanisms of injury. Neurological improvement, neurological deterioration, and mortality were compared between those sustaining TSI through an RTA versus non-RTA, using univariable and multivariable analyses.
A total of 626 patients were included, of which 302 (48%) were RTA-related. The median age was 34 years, and 532 (85%) were male. RTAs had a lower male preponderance compared to non-RTA causes (238/302, 79% vs. 294/324, 91%, p<0.001) and a higher proportion of cervical injuries (144/302, 48% vs. 122/324, 38%, p<0.001). No significant differences between RTA and non-RTA mechanisms were found in injury severity, time to admission, length of hospital stay, surgical intervention, neurological outcomes, or in-hospital mortality. Improved neurological outcomes were associated with incomplete injuries (AIS B-D), while higher mortality rates were linked to cervical injuries and complete (AIS A) injuries.
Our study in urban Tanzania finds no significant differences in outcomes between spinal injuries from road traffic accidents (RTAs) and non-RTA causes, suggesting the need for equitable resource allocation in spine trauma programs. Highlighting the critical link between cervical injuries and increased mortality, our findings call for targeted interventions across all causes of traumatic spinal injuries (TSI). 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An observational cohort study from Tanzania</title><author>Ikwuegbuenyi, Chibuikem Anthony ; Woodfield, Julie ; Waterkeyn, François ; Zuckerman, Scott L ; Cheserem, Beverly ; Leidinger, Andreas ; Lazaro, Albert ; Shabani, Hamisi K ; Härtl, Roger ; Mangat, Halinder S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c572t-15e10e04cbff307899c864ceec73ea33808d2b9e6bc9ca4e60b27b53aa26d6fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Accidents</topic><topic>Accidents, Traffic - statistics & numerical data</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Biology and Life Sciences</topic><topic>Cohort analysis</topic><topic>Comparative analysis</topic><topic>Computer and Information Sciences</topic><topic>Demographics</topic><topic>Engineering and Technology</topic><topic>Fatalities</topic><topic>Female</topic><topic>Fractures</topic><topic>Global health</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Injuries</topic><topic>Injury analysis</topic><topic>Injury prevention</topic><topic>Length of stay</topic><topic>Male</topic><topic>Males</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Motorcycles</topic><topic>Observational studies</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Pedestrians</topic><topic>Public health</topic><topic>Quality improvement</topic><topic>Resource allocation</topic><topic>Retrospective Studies</topic><topic>Roads</topic><topic>Sociodemographics</topic><topic>Spinal cord injuries</topic><topic>Spinal Injuries - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ikwuegbuenyi, Chibuikem Anthony</au><au>Woodfield, Julie</au><au>Waterkeyn, François</au><au>Zuckerman, Scott L</au><au>Cheserem, Beverly</au><au>Leidinger, Andreas</au><au>Lazaro, Albert</au><au>Shabani, Hamisi K</au><au>Härtl, Roger</au><au>Mangat, Halinder S</au><au>Ukachukwu, Alvan-Emeka K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is mechanism of injury associated with outcome in spinal trauma? An observational cohort study from Tanzania</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-07-18</date><risdate>2024</risdate><volume>19</volume><issue>7</issue><spage>e0306577</spage><pages>e0306577-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Traumatic spinal injury (TSI) is a disease of significant global health burden, particularly in low and middle-income countries where road traffic-related trauma is increasing. This study compared the demographics, injury patterns, and outcomes of TSI caused by road traffic accidents (RTAs) to non-traffic related TSI.
A retrospective analysis was conducted using a neurotrauma registry from the Muhimbili Orthopaedic Institute (MOI) in Tanzania, a national referral center for spinal injuries. Patient sociodemographic characteristics, injury level, and severity were compared across mechanisms of injury. Neurological improvement, neurological deterioration, and mortality were compared between those sustaining TSI through an RTA versus non-RTA, using univariable and multivariable analyses.
A total of 626 patients were included, of which 302 (48%) were RTA-related. The median age was 34 years, and 532 (85%) were male. RTAs had a lower male preponderance compared to non-RTA causes (238/302, 79% vs. 294/324, 91%, p<0.001) and a higher proportion of cervical injuries (144/302, 48% vs. 122/324, 38%, p<0.001). No significant differences between RTA and non-RTA mechanisms were found in injury severity, time to admission, length of hospital stay, surgical intervention, neurological outcomes, or in-hospital mortality. Improved neurological outcomes were associated with incomplete injuries (AIS B-D), while higher mortality rates were linked to cervical injuries and complete (AIS A) injuries.
Our study in urban Tanzania finds no significant differences in outcomes between spinal injuries from road traffic accidents (RTAs) and non-RTA causes, suggesting the need for equitable resource allocation in spine trauma programs. Highlighting the critical link between cervical injuries and increased mortality, our findings call for targeted interventions across all causes of traumatic spinal injuries (TSI). We advocate for a comprehensive trauma care system that merges efficient pre-hospital care, specialized treatment, and prevention measures, aiming to enhance outcomes and ensure equity in trauma care in low- and middle-income countries.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39024312</pmid><doi>10.1371/journal.pone.0306577</doi><tpages>e0306577</tpages><orcidid>https://orcid.org/0000-0003-3426-2001</orcidid><orcidid>https://orcid.org/0000-0003-3646-7713</orcidid><orcidid>https://orcid.org/0000-0002-0966-1062</orcidid><orcidid>https://orcid.org/0000-0003-3645-500X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2024-07, Vol.19 (7), p.e0306577 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3082558044 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Accidents Accidents, Traffic - statistics & numerical data Adolescent Adult Biology and Life Sciences Cohort analysis Comparative analysis Computer and Information Sciences Demographics Engineering and Technology Fatalities Female Fractures Global health Hospitals Humans Injuries Injury analysis Injury prevention Length of stay Male Males Medicine and Health Sciences Middle Aged Mortality Motorcycles Observational studies Orthopedics Patients Pedestrians Public health Quality improvement Resource allocation Retrospective Studies Roads Sociodemographics Spinal cord injuries Spinal Injuries - epidemiology Spinal Injuries - mortality Spine Surgery Tanzania - epidemiology Traffic Traffic accidents Traffic accidents & safety Trauma Traumatic brain injury Vehicles World health Young Adult |
| title | Is mechanism of injury associated with outcome in spinal trauma? An observational cohort study from Tanzania |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-21T18%3A11%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Is%20mechanism%20of%20injury%20associated%20with%20outcome%20in%20spinal%20trauma?%20An%20observational%20cohort%20study%20from%20Tanzania&rft.jtitle=PloS%20one&rft.au=Ikwuegbuenyi,%20Chibuikem%20Anthony&rft.date=2024-07-18&rft.volume=19&rft.issue=7&rft.spage=e0306577&rft.pages=e0306577-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0306577&rft_dat=%3Cgale_plos_%3EA801798169%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3082558044&rft_id=info:pmid/39024312&rft_galeid=A801798169&rft_doaj_id=oai_doaj_org_article_a90064d35e404a039d46ef9fa3ec82e5&rfr_iscdi=true |