Chronic Disease Comorbidities Among Injured Patients in Cameroon: A Retrospective Cohort Study.

Humans Trauma Centers Cameroon / epidemiology Retrospective Studies Injury Severity Score Chronic Disease
Cameroon Chronic disease Comorbidity Injury Sub-Saharan Africa Trauma

Journal

The Journal of surgical research
ISSN: 1095-8673
Titre abrégé: J Surg Res
Pays: United States
ID NLM: 0376340

Informations de publication

Date de publication:
12 2022
Historique:
received: 29 03 2022
revised: 20 05 2022
accepted: 16 06 2022
pubmed: 15 8 2022
medline: 25 10 2022
entrez: 14 8 2022
Statut: ppublish

Résumé

Chronic diseases are increasing but underdiagnosed in low-income and middle-income countries (LMICs), where injury mortality is already disproportionately high. We estimated prevalence of known chronic disease comorbidities and their association with outcomes among injured patients in Cameroon. Injured patients aged ≥15 y presenting to four Cameroonian hospitals between October 2017 and January 2020 were included. Our explanatory variable was known chronic disease; prevalence was age-standardized. Outcomes were overall in-hospital mortality and admission or transfer from the emergency department (ED). Associations between known chronic disease and outcomes were evaluated using logistic regression adjusted for age, gender, estimated injury severity score (eISS), hospital, and household socioeconomic status. Unadjusted eISS-stratified and age-stratified outcomes were also compared via chi-squared tests. Of 7509 injured patients, 370 (4.9%) reported at least one known chronic disease; age-standardized prevalence was 8.4% (95% confidence interval [CI] 7.5%-9.2%). Patients with known chronic disease had higher mortality (4.6% versus 1.5%, adjusted odds ratio [aOR]: 2.61 [95% CI: 1.25-5.47], P = 0.011) and were more likely to be admitted or transferred from the ED (38.7% versus 19.8%, aOR: 1.40 [95% CI: 1.02-1.92], P = 0.038) compared to those without known comorbidities. Crude differences in mortality (11.3% versus 3.3%, P = 0.002) and hospital admission or transfer (63.8% versus 46.6%, P = 0.011) were most notable for patients with eISS 16-24. Despite underdiagnosis among Cameroonians, we demonstrated worse injury outcomes among those with known chronic diseases. Integrating chronic disease screening with injury care may help address underdiagnosis in Cameroon. Future work should assess whether chronic disease prevention in LMICs could improve injury outcomes.

Identifiants

DOI: 10.1016/j.jss.2022.06.045 PMID: 35964485
pubmed: 35964485
pii: S0022-4804(22)00409-7
doi: 10.1016/j.jss.2022.06.045
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

74-84

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Auteurs

Kevin J Blair (KJ)

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California. Electronic address: kevin.james.blair@gmail.com.

Fanny N Dissak-Delon (FN)

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California; Littoral Regional Delegation, Ministry of Public Health, Douala, Cameroon.

Rasheedat Oke (R)

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California.

Melissa Carvalho (M)

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California.

Alan Hubbard (A)

Division of Biostatistics, School of Public Health, University of California Berkeley, Berkeley, California.

Mbiarikai Mbianyor (M)

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California.

Georges Alain Etoundi-Mballa (GA)

Department of Disease Epidemic and Pandemic Control, Ministry of Public Health, Yaoundé, Cameroon.

Thompson Kinge (T)

Hospital Administration, The Limbe Regional Hospital, Limbe, Cameroon.

Louis Richard Njock (LR)

Hospital Administration, The Laquintinie Hospital of Douala, Douala, Cameroon.

Daniel N Nkusu (DN)

Hospital Administration, The Catholic Hospital of Pouma, Pouma, Cameroon.

Jean-Gustave Tsiagadigui (JG)

Hospital Administration, The Edea Regional Hospital, Edea, Cameroon.

Rochelle A Dicker (RA)

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California.

Alain Chichom-Mefire (A)

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California; Faculty of Health Sciences, University of Buea, Buea, Cameroon.

Catherine Juillard (C)

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California.

S Ariane Christie (SA)

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California; Division of General and Trauma Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburg, Pennsylvania.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Chronic Disease Comorbidities Among Injured...
questionsmedicales.fr › Administration des services de santé › Organisation et administration › Administration d'établissement de santé › Administration hospitalière › Services hospitaliers › Service hospitalier d'urgences › Centres de traumatologie › Chronic Disease Comorbidities Among Injured...
questionsmedicales.fr › Régions géographiques › Afrique › Afrique subsaharienne › Afrique centrale › Cameroun › Chronic Disease Comorbidities Among Injured...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Chronic Disease Comorbidities Among Injured...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Score de gravité des lésions traumatiques › Chronic Disease Comorbidities Among Injured...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie chronique › Chronic Disease Comorbidities Among Injured...