Prehospital transport of patients with spinal cord injury in Nigeria

Background: A well-organized and efficient prehospital transport is associated with improved outcome in trauma patients. In Nigeria, there is paucity of information on prehospital transport of patients with spinal cord injury (SCI) and its relation to mortality. Objective: To determine if prehospital transportation is a predictor of mortality in patients with SCI in Nigeria. Design: Prospective cohort study Methods: Prehospital transport related conditions, injury arrival intervals and persons that brought patients with SCI to the casualty were noted. Data analyzed using descriptive statistics, the chi-square test and multiple logistic regressions. Main Outcome Measures: Mortality within 6 weeks on admission Results: 168 patients with SCI presented in the casualty during this review period. Majority (67.9%) presented after 24 hrs of the injury. Majority (58.3%) were conveyed into the casualty by their relatives. Salon car (54.2%) was the most common mode of transportation where majority (55.4%) laid on their back during the transfer. Majority (75%) of the patients had multiple hospital presentation before reporting in our casualty. The mortality observed was 16.7%. Multivariate analysis after adjusting for age, gender, and means of transportation revealed that age (OR = 63.41, 95% CI = 9.24-43.53), crouched position during transfer (OR = 23.52, 95% CI = 7.26-74.53), presentation after 24 hrs (OR = 5.48, 95% CI = 3.20-16.42) and multiple hospital presentation (OR = 7.94, 95% CI = 1.89-33.43) were associated with mortality within 6 weeks of admission. Conclusion: A well-organized and efficient prehospital transport would reduce mortality in spinal cord injured patients. Public enlightenment campaign on factors that could reduce road traffic injury would help reduce mortality.