Trauma care and predictors of mortality at a single-centre trauma hospital in Ethiopia: A prospective observational study

Trauma accounts for 11 % of the total global burden of disease and is the leading cause of death in individuals under 40 years of age. Ethiopia faces a substantial task in establishing well-equipped and sufficiently staffed emergency departments. Moreover, current research in Ethiopia concentrates on trauma epidemiology and specific trauma types to guide evidence-based intervention strategies rather than emphasising trauma care features. Thus, this study aims to explore the trauma care process and investigate the predictors of ED mortality at a single-centre trauma hospital in Ethiopia. We conducted a single-centre prospective observational study at Addis Ababa Burn Emergency and Trauma Hospital in Ethiopia. Observations were conducted from November 30, 2022, to May 24, 2023. The study included patients admitted with reported major injuries during the study period. Descriptive statistics and multivariate logistic regression were applied to explore predictors of ED mortality. The cohort consisted of 425 patients, 73.4 % were male, and the median age was 32 years. Of the patients, 188 (44.4 %) met the criteria for trauma team activation, but none received treatment from such teams. Among the patients in need of emergency procedures, 22.6 % experienced delays within 48 h of observation. Epidural or subdural haematoma was diagnosed in 37.1 % of patients, but fewer patients underwent a craniotomy procedure. A small percentage of patients stayed in the ED for less than 24 h (13.4 %), while ED mortality was 10.4 %. Lower Glasgow Coma Scale, haematoma presence and shorter length of ED stay were associated with increased odds of ED mortality. Close to half of the participants met the criteria for trauma team activation, but none received treatment from such teams.