Abstract:
Background: Globally 20-50 million people suffer road traffic injuries (RTIs) and
majority lead to disabilities. Outcomes of RTI amongst Inpatients (hospitalized
patients) have been widely studied in Kenya whereas very few have followed up the
outpatient (non-hospitalized) group whose injuries mostly have been considered
minor. Studies have reported significant disability among the non-hospitalized
victims. This study investigated sub-acute phase disabilities (SAPDs) that is
disabilities between ten and twelve weeks post injury amongst hospitalized and non-hospitalized
patients and factors associated with SAPDs.
Objective: To determine characteristics of Road Traffic Injuries and sub-acute phase
disabilities amongst hospitalized and non-hospitalized patients managed at Webuye
County Hospital
Methods: A prospective cohort study of 184 participants was done in the emergency
department and surgical wards in Webuye County Hospital. RTIs were dichotomized
into hospitalized (n=92) and non-hospitalized (n=92). Patients who met the inclusion
criteria and consented were consecutively sampled. Interviewer-administered
questionnaires were used to collect socio-demographics and injury details. Injury
severity was assessed using the Kampala trauma score. SAPDs were assessed using
the World Health Organization disability schedule (WHODAS) tool 8-10 weeks post
injury. Categorical variables were summarized as frequencies and percentages and
continuous variables as means and median. Chi-square and Fisher’s exact tests were
used to check for associated factors to SAPDs. A p value ≤0.05 was considered
significant.
Results: The ages of the patients ranged from 16 to 63, mean age of 33.8 (SD 13.7)
and a male:female ratio 3:1. Most of the victims (72.8%) were either unemployed or
casual laborers. Some patients had multiple injuries but the most prevalent were lower
limbs (69.5%), upper limbs (43.5%) and head/face (32.1%). On injury severity, 73.9
% of the hospitalized patients had mild injuries and 25% moderate injuries while
91.3% of the non-hospitalized were mild and 8.7% moderate. Most patients suffered
severe SAPDs (hospitalized 92.4% , non-hospitalized 66.3%). Factors associated with
with severity of SAPDs were hospitalization with an adjusted risk ratio (ARR) 1.406
(p<0.001) and multiple injuries ARR 1.298 (p=0.001).
Conclusions: Even though the hospitalized group had a higher proportion of severe
SAPDs , more than half of the non-hospitalized group had severe SAPDs as well.
Recommendations: An assessment for SAPDs should be made for the non-hospitalized
patients and prompt follow up made.