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Preventable Trauma Deaths and Corrective Actions to Prevent Them: A 10-Year Comparative Study at the Komfo Anokye Teaching Hospital, Kumasi, Ghana

  • Surgery in Low and Middle Income Countries
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Objective

To determine the rate of preventable trauma deaths in an African hospital, identify the potential effect of improvements in trauma care over the past decade and identify deficiencies in care that still need to be addressed.

Methods

A multidisciplinary panel assessed pre-hospital, hospital, and postmortem data on 89 consecutive in-hospital trauma deaths over 5 months in 2017 at the Komfo Anokye Teaching Hospital. The panel judged the preventability of each death. For definitely and potentially preventable deaths, the panel identified deficiencies in care.

Results

Thirteen percent (13%) of trauma deaths were definitely preventable, 47% potentially preventable, and 39% non-preventable. In comparison with a panel review in 2007, there was no change in total preventable deaths, but there had been a modest decrease in definitely preventable deaths (25% in 2007 to 13% in 2017, p = 0.07) There was a notable change in the pattern of deficiency (p = 0.001) with decreases in pre-hospital delay (19% of all trauma deaths in 2007 to 3% in 2017) and inadequate resuscitation (17 to 8%), but an increase in delay in treatment at the hospital (23 to 40%).

Conclusions

Over the past decade, there have been improvements in pre-hospital transport and in-hospital resuscitation. However, the preventable death rate remains unacceptably high and there are still deficiencies to address. This study also demonstrates that preventable death panel reviews are a feasible method of trauma quality improvement in the low- and middle-income country setting.

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Acknowledgement

This study was funded by grant D43-TW007267 from the Fogarty International Center of the US National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding

This study was funded by grant D43-TW007267 from the Fogarty International Center of the US National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Directorate of Trauma and Orthopaedics, Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Dominic Konadu-Yeboah, Kusi Kwasi & Senyo Gudugbe

  2. Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Peter Donkor, Augustus Okleme & Frank Nketiah Boakye

  3. Department of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Ossei Sampen

  4. Directorate of Emergency Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Maxwell Osei-Ampofo

  5. Department of Anaesthesia, Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Helena Okrah

  6. Department of Surgery, University of Washington, Harborview Medical Center, 325 Ninth Avenue, Box 359960, Seattle, WA, 98104, USA

    Charles Mock

Authors
  1. Dominic Konadu-Yeboah
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  2. Kusi Kwasi
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  3. Peter Donkor
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  4. Senyo Gudugbe
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  5. Ossei Sampen
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  6. Augustus Okleme
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  7. Frank Nketiah Boakye
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  8. Maxwell Osei-Ampofo
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  9. Helena Okrah
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  10. Charles Mock
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Corresponding author

Correspondence to Charles Mock.

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Conflict of interest

None declared by any of the authors.

Ethical approval

The study was approved by the Committee for Human Research and Publication Ethics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

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Konadu-Yeboah, D., Kwasi, K., Donkor, P. et al. Preventable Trauma Deaths and Corrective Actions to Prevent Them: A 10-Year Comparative Study at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. World J Surg 44, 3643–3650 (2020). https://doi.org/10.1007/s00268-020-05683-z

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  • DOI: https://doi.org/10.1007/s00268-020-05683-z

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