Prevalence and presentation of spinal injury in patients with major trauma admitted in Mulago Hospital.

Abstract

BACKGROUND: Spinal injury is a major cause of morbidity, mortality and long bed occupancy in patients admitted in Mulago hospital. Several studies have reported different incidence and different presentations of spinal injury (1-4). At Mulago Hospital, road traffic crushes (RTC) is one of the most common causes of these injuries (5). However, the magnitude of the problem is unknown and this impacts on planning of services. OBJECTIVE: To determine the prevalence and presentation of spinal injury among patients with major trauma admitted in Mulago Hospital. METHODOLOGY: A Cross sectional descriptive study was done on 669 patients with major trauma admitted in the accident and Emergency ward of Mulago Hospital. Newly admitted patients were consecutively enrolled in the study. Data was collected using questionnaires capturing information from relevant history, physical examination and X-ray interpretation. This was done between November 2008 and January 2009. Data was entered into the Epi-data statistical programme and exported to SPSS statistical programme for analysis. RESULTS: Of the 669 patients enrolled, 59 had spinal injury thus giving a prevalence of 8.8%. Most of the patients had neurological involvement and Frankel A was the most common neurological sign. All patients had X-rays done and fracture was the most common radiological diagnosis and the majority of the respondents has unstable spine. Long bone fractures were the most common associated injury. CONCLUSIONS AND RECOMMENDATION: The prevalence of spinal injury among the trauma patients is 8.8% with Frankel A score being the most common neurological injury, while fractures being the most common radiological diagnosis. There should be measures instituted by the policy makers to prevent spinal injury. The hospital should be fully equipped to manage spinal injury patients before they go back into the community.