Les traumatismes abdominaux en Haïti.

Abstract

Context: Abdominal trauma (AT) appears to be frequent in Haiti, which is confronted with recurrent socio-political violence.

Objective: To study patients admitted for AT to the Médecins Sans Frontières (MSF) Tabarre trauma centre (Port-au-Prince), and the circumstances of occurrence.

Design: This was a cross-sectional study with retrospective data from January 2020 to December 2021.

Results: Of 3,211 patients admitted for trauma, 541 (17.3%) had an AT, of which 500 (91.4%) were related to sociopolitical events. Their median age was 30 years (interquartile range [IQR] 23-38); 429 (85.8%) were male. A gunshot wound was noted in 371 (74.2%). The median distance from the scene of violence to the hospital was 11 km (IQR 7-15); however, 9 (1.8%) came within 1 hour of the trauma; transfusion was not done or insufficient in 169 (33.8%). An adverse outcome (death, referral, discharge against medical advice) was noted in 57 (11.4%), with 8.0% of deaths. Political instability was the main cause of violence. An adverse outcome was associated with inadequate transfusion (hazard ratio [HR] 2.4, 95% CI 1.4-4.3; P = 0.006) or gunshot wound (HR 2.4, 95% CI 1.1-5.2; P = 0.002).

Conclusion: Firearm injuries were common during the period of sociopolitical events 2020-2021. The lack of blood products had a negative impact on patient outcomes. Safety measures and blood collection still need to be maintained and strengthened.