Journal of Trauma and Injury

Original Articles

Clinical predictors of therapeutic laparotomy in anterior abdominal stab injuries: a multicenter study from low-income institutions in Ethiopia: Segni Kejela, Abel Hedato, Yeabsera Mekonnen Duguma, Meklit Solomon Gebremariam; J Trauma Inj. 2024;37(2):140-146. Published online June 19, 2024; DOI: https://doi.org/10.20408/jti.2024.0009

3,677 View
76 Download

Abstract PDF: Purpose
Despite the high incidence of abdominal stab injuries, the rate of nontherapeutic laparotomies and the predictors of therapeutic laparotomies have rarely been studied in low-income settings.
Methods
This multicenter retrospective study involved three of the largest academic medical centers in central Ethiopia. All patients who sustained an anterior abdominal stab injury and underwent exploratory laparotomy, regardless of the intraoperative findings, were included over the 3-year course of the study.
Results
Of the 117 patients who underwent exploratory laparotomy, 35 patients (29.9%) underwent nontherapeutic laparotomies. Three factors predicted therapeutic laparotomy: hollow viscus evisceration (adjusted odds ratio [AOR], 5.77; 95% confidence interval [CI], 1.16–28.64; P=0.032), localized and generalized peritonitis (AOR, 4.77; 95% CI, 1.90–11.93; P=0.001), and white blood cell count ≥11,500/mm3 (AOR, 2.77; 95% CI, 1.002–7.650; P=0.049). The overall positive predictive value of the therapeutic predictors was 80.2%, while the negative predictive value of all predictor-negative patients was 58.1%. The predictors would have prevented 51.4% of the nontherapeutic laparotomies.
Conclusions
Close to one-third of the patients had a nontherapeutic laparotomy. The clinical predictors of therapeutic laparotomy were shown to have a high positive predictive value despite a lower negative predictive value. Further prospective studies that involve all patients who sustain anterior abdominal stab injuries are needed to potentially improve on the negative predictive value of the predictors suggested by our study.; Summary

Implementation of structured trauma training for first-year surgical residents in Ethiopia: a novel pilot program in a low income country: Segni Kejela, Meklit Solomon Gebremariam; J Trauma Inj. 2024;37(2):132-139. Published online June 12, 2024; DOI: https://doi.org/10.20408/jti.2024.0010

4,179 View
59 Download
1 Web of Science
1 Citations

Purpose
Curricula for surgical residents should include training in trauma care; however, such training is absent in many low income countries. At the largest surgical training institution in Ethiopia, a trauma training program was developed, integrated into the existing surgical curriculum, and implemented. This study was conducted to evaluate the trainees’ response to the new program.
Methods
Over a 5-month period, 35 first-year surgical residents participated in weekly trauma care training sessions. The program included journal clubs, practical sessions, didactic sessions, and case-based discussions. Six months after the conclusion of the training, changes in knowledge, attitude, and practices were evaluated through a self-report survey.
Results
For knowledge-based items, the survey data revealed reported improvements in 83.8% to 96.8% of students. Furthermore, 90.3% to 93.5% of participants indicated improvements in practice, while 96.7% exhibited a change in attitude. Respondents reported that attending didactic courses improved their presentation skills and facilitated the acquisition of knowledge. They suggested the inclusion of additional practical sessions.
Conclusions
Training structures that are simple to implement are crucial for residency programs with limited resources. Such programs can be developed using existing academic staff and can aid residents in delivering improved care to trauma patients.

Summary

Citations

Citations to this article as recorded by

Improving Trauma Care and Prevention in the COSECSA Region: A Review of Trauma Data Utilization
Paul Serrato, Claudia Kabanyana, Fabrizio Darby, Louise Atadja, Bennadettee Biton, Grace Kansayisa, Penelope Kantu Machona, Melanie Sion, Chifundo Kajombo
World Journal of Surgery.2025; 49(11): 3257. CrossRef

Acute pain management in the trauma patient population: are we doing enough? A prospective observational study: Segni Kejela, Nebyou Seyoum; J Trauma Inj. 2022;35(3):151-158. Published online June 3, 2022; DOI: https://doi.org/10.20408/jti.2021.0068

9,808 View
327 Download
5 Web of Science
6 Citations

Abstract PDF

Purpose
There is a strong correlation between trauma and pain. Pain increases the rate of depression, posttraumatic stress disorder, and even mortality in trauma patients.
Methods
This institution-based, provider-blinded and patient-blinded, observational study was conducted among trauma patients treated at a specialized center . Over the course of 3 months, this study included patients who had no prior pain management at other hospitals before presentation, and who presented within 24 hours of the traumatic event.
Results
Of the 74 patients evaluated, none of the patients had their pain level scored. The researcher-provided pain scale showed a severe subjective pain score for 79.7% of the patients and a severe functional activity score for 59.5% of the patients. Analgesia was provided at an average of 55.4 minutes after presentation and all patients received either diclofenac or tramadol. Satisfactory pain reduction after analgesia was 28.8% for patients initially complaining of severe pain, 54.6% for moderate pain, and 66.7% for mild pain, with the difference being statistically significant (P<0.05). Forty percent of patients discharged home received no analgesia after the first dose provided upon presentation.
Conclusions
Pain scoring was nonexistent during the course of the study. The poor utilization rate of analgesia combination and opioids led to unsatisfactory pain outcomes in patients evaluated and followed for 24 hours after presentation.

Summary

Citations

Citations to this article as recorded by

Ketamine versus morphine for musculoskeletal trauma pain: a meta-analysis of randomized controlled trials
Mansoureh Fatahi, Alireza Ebrahimi, Saba Aghajani, Melika Arab Bafrani, Reham Hamouda, Masoud Mayel
European Journal of Orthopaedic Surgery & Traumato.2026;[Epub] CrossRef
Sex-based differences in analgesic administration in trauma patients
Teodora Krstić, Milovan Radulović, Aleksandar Đuričin, Nikolina Marić, Zelić Jokšić, Luka Ivanišević, Aleksandra Petrić, Vesna Aleksić, Radojka Jokšić-Mazinjanin
ABC - casopis urgentne medicine.2026; 26(1): 21. CrossRef
Depremde çoklu travma yaklaşımı ve ağrı yönetimi
Yücel Olgun
Ağrı Tıp Fakültesi Dergisi.2025; 3(1): 1. CrossRef
The 7 Pillars of Pain Management for Minimally Invasive Cardiac Surgery
Alexander J. Gregory, Christopher D. Noss, William D. T. Kent, Corey Adams, Rakesh C. Arora, Rawn Sallenger
Innovations: Technology and Techniques in Cardioth.2025; 20(4): 331. CrossRef
Enhancing Pain Management in Trauma Patients Through Education of Residents: An Interventional Study
Maanas Jain, Janhvi Shah, Marina Kharkongor, Niladri Banerjee, Supreet Kaur, Mahaveer Singh Rodha, Naveen Sharma
World Journal of Surgery.2025; 49(11): 3282. CrossRef
Role of Regional Anesthesia in Intensive Care: An Updated Narrative Review
Lizbeth Hu, Moodakare Ashwini Bhat, Kellie Marie Jaremko
Turkish Journal of Intensive Care.2024; 22(4): 225. CrossRef

First
Prev
Page of 1
Next
Last

Search