Post-graduate Dissertations (Medical School)

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    Short term poor outcome determinants of patients with traumatic pelvic fractures: a crossectional study at three private not for profit hospitals of Nsambya, Lubaga and Mengo.
    (Uganda Martyrs University, 2019-10-30) Osuta, Hope Methuselah
    Background: Although relatively rare, pelvic fractures signify major trauma that are frequently associated with multiple injuries, threat to life and poor functional outcome. This study aimed to establish poor outcome determinants in traumatic pelvic fracture patients admitted and treated at three urban PNFP Hospitals in Kampala. Methods: A cross-sectional study reviewing charts of patients admitted and treated at three urban PNFP hospitals in Kampala, Uganda between January 2014 and December 2018. A pretested data abstraction form was used to obtain data. All variables with a p-value < 0.24 at bivariate logistic regression were included in multivariate analysis. A backward stepwise elimination method was used to identify predictors of poor outcome, with Odds Ratios at 95% confidence intervals used to report results. Data was analyzed using STATA version 14.0 at a p-value < 0.05. Results: Of the 73 patients admitted and treated for pelvic fractures, 40(54%) were males and the mean age of 37.4± 17.7 years. Overall, 83.3% fractures were stable while 16.7% were unstable. The most commonly associated injuries were in extremities (52.38%), head and neck region (25.40%), abdomen (7.94%) and chest regions (7.94%). Factors significantly associated with poor outcome among patients with pelvic fractures were surgical intervention (p = 0.001) and poor heart rate (p = 0.008), regardless of whether stable or unstable pelvic fractures. Conclusion: Poor Outcome determinants for pelvic fracture were operational interventions and elevated heart rate. Associated injuries were mainly in the extremities and head and neck regions. Deliberate and focused attention should be given to stabilize the cardiovascular system in pelvic fracture patients who present with elevated heart rate. Very close monitoring of pelvic fracture patients who require or have undergone operative intervention is very essential for optimal outcome.