Delay in Craniomaxillofacial Trauma Care at University Teaching Hospital of Kigali (CHUK)

Abstract

Introduction

Craniomaxillofacial (CMF) trauma comprises a significant proportion of global surgical disease burden, disproportionally impacting low and middle-income countries where care is often delayed. We investigated the reasons for delay in CMF trauma care and the effect on patient outcomes.

Methodology

This was a cross-sectional prospective study of all patients with diagnosis of CMF trauma presenting to the University Teaching Hospital of Kigali (CHUK) between June 1, 2020 and June1, 2021. It enrolled 54 participants. Epidemiologic data was collected, and logistic regression analysis was undertaken to explore risk factors for delays in care and complications.

Results

Male accounted for 51 (94.4%) of CMF trauma cases. Mean age was 30 years (range 4 - 65 years). The majority of patients presented from a rural setting (63% n=34), the most common cause of trauma was motor vehicle accident (n=18, 33%), and the most common injury was mandibular fracture. 78% of patients had delayed treatment of their fracture after arrival to the hospital, 81% of these patients with delayed treatment experienced a complication (n=34, chi-squared p=0.03). Delay in treatment was associated with 4 times greater likelihood of complication (OR 4.25 (95% CI 1.08-16.70, p=0.038).

Conclusion

Delay in treatment of CMF traumatic injuries correlates with higher rates of post-operative complications. Delays most commonly resulted from lack of surgeon and/or operating room availability, or were related to transfers from rural districts.