Assessing the Efficacy in the Regulation of recreational noise pollution in emerging Urban Centres in Kenya

Abstract

Introduction: Trauma is one of the leading causes of morbidity and mortality worldwide. Neck injuries are on the rise with the morbidity and mortality experienced from these injuries being very significant. Objective: To determine the patterns and outcomes of neck injuries seen at the Kenyatta National Hospital. Study methodology: The study was a prospective observational study carried out over a period of 10 months. Thirty-eight patients who presented with neck injury during this period were recruited after obtaining consent. Patients’ history was taken and physical examination done, and they were followed up through investigation and management. Patients were reviewed at one week and at one month for complications. Data was collected using a questionnaire. Descriptive statistics and correlation analysis were done, with statistical significance set at a P value of <0.05 at 95% confidence interval. The independent sample T-test and Fischer’s exact test were used for this analysis. Results: Thirty-eight patients were recruited in the study.The prevalence of neck injury was 0.2% of A&E admissions and 0.9% of trauma cases. Penetrating neck injuries were common (92%) and mostly involved zone II (68%). Most injuries were secondary to assault (60%), with 24% resulting from suicide attempts. Thirty-four patients underwent neck explorations, with a positive rate of 85.3%. There was a mortality of 2.6% during the study period. Late presentation was a predictor of development of complications (P=0.03). Complications in the first week of management was a determinant of complications a month later (P<0.001). Patients with complications had longer hospital stay (P<0.001) Conclusion: The present study demonstrates that neck injuries are not common in our setting with a prevalence of 0.2% of A&E admissions and 0.9% of trauma admissions. Penetrating neck injuries were more common with a majority being in Zone II and secondary to assault. There was a high rate of positive neck explorations with muscle injuries. Longer duration from injury to definitive management was associated with increased risk of developing complications. Having early complications was a determinant of late complications.