Patterns of Injury and Discharged Against Medical Advice among Road Traffic Accident Victims in a Tertiary Hospital, North Central Nigeria

Abstract

Aim: Discharged against Medical Advice with its attendant effects of increased cost and mortality is common globally. The aim of this study was to highlight the Patterns of injuries by Road Traffic Accident victims, the implications of Discharged against Medical Advice on certain critical injuries, and the importance of follow up. Methods: A retrospective study was carried out at the Federal Medical Centre Makurdi, a tertiary health facility in North Central Nigeria, from January 2021 to March 2022. Data was extracted from medical records (case notes) of all patients who were involved in Road Traffic Accidents (RTAs), and were admitted either into the ward through the Accident and Emergency Unit, or at the Accident and Emergency Unit of the hospital. A total of 121 patients were admitted, 15 were discharged against Medical Advice, while others were either discharged home or referred to other health facilities. Descriptive Statistics was deployed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) to analyze the data. Results: Of a total of 121 patients admitted for various injuries due to RTAs, there were 15 (12.4%) of DAMA, with 8 females (6.6%) and 7 (5.7%) males. Head injury was the commonest injury 8 (53.3%) seen, while musculoskeletal injuries were 7 (46.7%). Majority of the victims, 6, were in the age group, 30-39 years, with an average age of 37.2. Farmers and House Wives were the dominant occupational groups involved. There was no tracking or follow up. Average hospital stay was 6 days. There was no any form of health insurance coverage, or follow up. Conclusion: DAMA for critically injured patients is common in our environment, and there is no any known established follow up system. There is no health insurance coverage. Physicians must strive to track and follow up on these patients to improve outcomes.