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MI’s Still Trauma Surgeons’ Retribution Introduction: Missed Injuries (MI’s) have been noted in as many trauma centers worldwide as have studied them. They are a significant cause of patient morbidity and mortality. The situation with MIs in Mulago Hospital was unknown. Objectives: To establish the prevalence, contributing factors and short-term outcome of MIs in patients with multiple and or major trauma. Methods: Longitudinal, Prospective involving 403 patients, over 5 months. Results: Seventy eight patients had MIs (prevalence 19.4%). Contributing factors included incomplete assessment (54%), radiological errors and Surgical Failures. The most affected AIS body regions were the Head and Neck, extremities and pelvic girdle. Per body region, 49.1% of injuries in the abdomen were missed. 21 of 28 deaths in the study were in the MIs group with 13 (62%) of these deaths directly attributable to the MIs. Conclusion: The Prevalence of missed injuries in Mulago Hospital is 19.4%. The MIs were responsible for 62% of the deaths as well as other complications including prolonged hospital stay, peritonitis, limb loss amongst others. Recommendation: There is need for improvement in patient assessment and monitoring, efficiency of the trauma team, redistribution of A & E staff to address the increasing night arrivals and a round the clock availability of a consultant. |
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