Clinical Diagnosis Versus Autopsy Findings in Trauma Patients With Musculoskeletal Injuries Managed at the Kenyatta National Hospital

Abstract

Background Trauma is the leading cause for patients needing orthopaedic care in the accident and emergency department at The Kenyatta National Hospital and hence requiring admission. Globally, Trauma accounts for one tenth of the total burden of disease with the most catastrophic outcomes occurring in developing countries. The World Health Organization in its outline on trauma management and establishment of trauma centres emphasizes on the importance of understanding the trauma patterns as an effort to improve the care given to these patients and guide policy making. To this date, no study has been done locally correlating the clinical diagnosis to autopsy findings of trauma patients. Subsequently, there is inadequate evidence based interventions that have been made towards improving the outcomes of trauma patients in Kenya at the Kenyatta National Hospital. Aim: The aim of this study was to correlate the clinical diagnosis to the findings at autopsy for trauma patients with musculoskeletal injuries managed at The Kenyatta National Hospital. Methodology Prospective cross sectional study at the Kenyatta National Hospital where the clinical diagnosis of polytrauma patients with musculoskeletal injuries was be recorded, and mortalities followed to autopsy at the Kenyatta National hospital mortuary. Patients who presented with severe injuries and managed by the orthopaedic team but die in the accident and emergency department or in the Intensive care unit/High Dependency Unit were also be followed through and included in the study. Statistical analysis Data was collected using a data collection form which included the admission diagnosis and the autopsy findings. It was then exported to STATA 15 statistical software for further analyses. The descriptive statistics used to summarize the data included median, frequencies, proportions, and percentages. The inferential statistics used include Cramer’s V test for correlation between categorical variables and logistic regression was used to produce relative risk (RR) ratios, confidence intervals and probability value (p-value). The hypothesis testing was done at 95% confidence interval.........................................................................................................