Background Little is known about long-term functional outcomes of trauma patients in low-income and middle-income countries. In sub-Saharan Africa most studies of injury only collect data through emergency department disposition or hospital discharge, and methods of collecting long-term data are subject to significant bias. With the recent increase in access to mobile telephone technology, we hypothesized that structured, telephone-administered interviews now offer a feasible means to collect data about the long-term functional outcomes of trauma patients in urban Ethiopia.
Methods We piloted a telephone-administered interview tool based on the Glasgow Outcome Scale-Extended. Using departmental logbooks, 400 consecutive patients presenting to two public referral hospitals were identified retrospectively. Demographics, injury data, and telephone numbers were collected from medical records. When a telephone number was available, patients or their surrogates were contacted and interviewed 6 months after their injuries.
Results We were able to contact 47% of subjects or their surrogates, and 97% of those contacted were able and willing to complete an interview. At 6-month follow-up, 22% of subjects had significant persistent functional disability. Many injuries had an ongoing financial impact, with 17% of subjects losing or changing jobs, 18% earning less than they had before their injuries, and 16% requiring ongoing injury-related medical care. Lack of documented telephone numbers and difficulty contacting subjects at recorded telephone numbers were the major obstacles to data collection. Language barriers and respondents’ refusal to participate in the study were not significant limitations.
Discussion In urban Ethiopia, many trauma patients have persistent disability 6 months after their injuries. Telephone-administered interviews offer a promising method of collecting data about the long-term trauma outcomes, including functional status and the financial impact of injury. These data are invaluable for capacity building, quality improvement efforts, and advocacy for injury prevention and trauma care.
Level of evidence III, retrospective cohort study.
- global trauma
- functional status
- research methods
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Presented at This research was presented at the 4th World Trauma Congress in San Diego, California, on September 28, 2018.
Contributors All authors meet the ICMJE criteria for authorship. ADL, CJJ, and RAD participated in the conception and design of the study. ADL, NS, AA, and AZ participated in the acquisition of data. All authors participated in the analysis and interpretation of data. ADL drafted the article. NS, AA, AZ, CJJ, and RAD participated in the critical revision of the article. All authors approved of the final version of the article.
Funding This project was supported by the NIH Fogarty International Center (Grant #R25TW009338) under the Global Health Equity Scholars Consortium.
Competing interests None declared.
Patient consent Informed consent for telephone-administered interviews was obtained verbally at the time of interview.
Ethics approval The study protocol was reviewed and approved by the Institutional Review Board at Addis Ababa University and the Committee on Human Research at the University of California, San Francisco.
Provenance and peer review Not commissioned; internally peer reviewed.
Data sharing statement There are no additional unpublished data from the study which are available to share.
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