The Care of Injured Patients Admitted to Mulago National Referral Hospital in Kampala, Uganda

Background: Injury represents a growing global health crisis. Uganda, like much of Sub-Saharan Africa, faces little pre-hospital and medical infrastructure, severe shortages of healthcare workers and a large and growing disease burden from injury. This study aimed to describe the epidemiology of injured patients admitted to Mulago National Referral Hospital in Kampala, Uganda and determine their use of surgical resources. Methods: We used data from a cross-sectional study in 2007-08 involving 1833 patients admitted to Mulago Hospital with ICD 10-based injury diagnoses to analyze inpatient injury care based on demographics, mechanism of injury, diagnosis, operative care, hospital length of stay, and outcomes. Results: The median age was 25y, 76% were men. Injuries from road traffic crashes (61%) or assault (25%) resulted orthopedic (37%) or head injuries (28%). 30% of patients (n=542) underwent operation, mostly orthopedic (n=312, 58%). Needing operations and needing orthopedic procedures had longer hospital stays (6d vs. 1, p<0.0001) and (11d p<0.0001), respectively. Only four cases of intracranial drainage and 58 deaths were noted (3%). Conclusions: Orthopedic and head injuries are main causes for injury-related admission to Mulago Hospital. Patients requiring orthopedic procedures have long stays. Tracking injury morbidity and mortality is a worthwhile priority in this setting, but require greatly improved medical record systems and public health surveillance.