Abstract

One of the improvements in Ethiopia’s emergency medical system was the introduction of a five level Emergency Triage System (ETS) in January 2015 that was piloted in selected Addis Ababa hospitals. This study aims to assess the effect of this intervention on the head injury mortality in Tikur Anbessa Specialized Hospital (TASH) Emergency Department (ED).

Data were retrospectively collected from all medical records of head injury patients seen in Adult TASH- ED over two 6 months periods, before and after the new Emergency Triage System implementation: 01/04/2014 – 30/09/2014 versus 01/04/2016 – 30/09/2016. An inclusion criterion was age above 13 for whom records could be retrieved. Exclusion criterion was ‘patient declared dead on arrival’. Mortality and patterns of head injury were compared pre and post intervention. Chi square was used for the analysis using STATA 14.

A total of 522 Head injury patients were analyzed in the ED in both the pre- 258 and post-264 intervention study periods. Among head injury admission in the ED in both study periods, the highest number of patients were Road Traffic Accident/RTA/victims, males and young age (<30). Mortality rate among head injury patients decreased from a pre-intervention 44 (17.05%) to post-intervention 27 (10.2%) (OR=0.55, 95% CI (0.32, 0.95), p=0.02).The median age of death were 45 years in pre- and 40 years in post-intervention period with ages ranging from 13 to 85 and 13 to 96 years respectively. The proportion of deaths from moderate head injury decreased significantly from 14.0% in pre-intervention to 6.3% in post-intervention period respectively (p<0.001).

In Conclusion Emergency Triage System at TASH-ED has decreased mortality caused by head injury. This could increases life-years saved and productivity in a cost effective and easily achievable way in resource poor settings.