Proportion and Associated Factors of Delayed Presentation among Patients with Open Fracture at Tibebe Ghion Specialized Hospital, Bahir Dar, North West Ethiopia

Abstract

Background: Clinical experience shows most patients with open fracture present late in Ethiopia. Delayed treatment associated with worst outcome and can worsen disability. Understanding associated factors for delayed hospital presentation will assist in guiding proper open fracture management. Objective: This study aims to assess the proportion of delay in hospital presentation and associated factors among patients with open fracture. Methods: this is institution based cross sectional study. We examined the records of 309 patients with open fracture ho presented to Emergency Department at Tibebe Ghion Specialized Hospital in Bahr Dar Ethiopia. J Ortho Sports Med 2022; 4 (2): 187-198 DOI: 10.26502/josm.511500054 Journal of Orthopaedics and Sports Medicine 188 We used bivariate and multivariate logistic regression to evaluate the association between presentation to a hospital with in 2hrs after the injury (delayed presentation) and seven covariates: age, sex, occupation, address, injury mechanism, injured limb and site of fracture. Results: Men accounted for about 84.8%, with a mean age of 30.33 years. The most common injury mechanism was Bullet/Blast injury in 165 (53.4%) patients, followed by road traffic accident in 75 (24.3%) patients. About 90.9% of open fractures did not present to the hospital within the Lancet Commission on Global Surgery recommended 2 hours’ time frame. Being from rural areas independently increased the risk of delayed presentation (Adjusted odds ratio, 3.327(95% CI 1.140 to 9.712)). Relative to other mechanism of injury, Bullet/Blast injury demonstrated a 69.3% reduced risk of late presentation after having open fracture (adjusted OR 0.307 (95% CI 0.122 to 0.776)). Conclusions: our study shows a significant delay among open fractures in our set up from trauma to hospital arrival and identify factors for delayed presentation. Interventions are needed to improve access to fracture care. We recommend further prospective multicenter research to identify many more factors responsible for open fracture delayed presentation.