Urgences traumatiques en milieu africain Analyse de 66 dossiers de patients admis en réanimation

Objective This study concerns a 2-year experience on trauma intensive care. Principal epidemiological characteristics and lesions are studied and their management and evolution are described. Severity indices are used for assessment of injury severity and results of trauma care. Method This retrospective study follows the period of January 1995 to December 1996. Sixty-six traumatized patients were admitted to the intensive care unit of Libreville Hospital Center, Gabon. Medical files were used as data sources. Different severity indices were used for trauma severity evaluation and results analysis: Injury Severity Score (ISS), Abbreviated Injury Score (AIS) and TRISS methodology. Results Road accidents were the most frequent circumstances (63.6%), primarily responsible for blunt injuries. Attacks were responsible for penetrating injuries. Young people were the most affected, with a sex ratio favoring men. Head injuries were predominant (69.8%). Surgery was used for treating essentially abdominal lesions. Mortality, most often following head injuries, concerned 20 patients (30.3%). It was correlated to the severity of injuries defined by the different scores. However, deaths occurred even when they were not foreseen by the estimated probability of survival. Conclusion The absence of pre-hospital management, indeed hospital management before the intensive care unit, and a practice characterized by limited resources, explain the high rate of post trauma mortality in Africa.