BMC Emergency Medicine (Apr 2024)

Mortality and its predictors in abdominal injury across sub-Saharan Africa: systematic review and meta-analysis

  • Destaw Endeshaw,
  • Amare Mebrat Delie,
  • Ousman Adal,
  • Abiyu Abadi Tareke,
  • Eyob Ketema Bogale,
  • Tadele Fentabel Anagaw,
  • Misganaw Guadie Tiruneh,
  • Eneyew Talie Fenta

DOI
https://doi.org/10.1186/s12873-024-00982-3
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 15

Abstract

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Abstract Background Abdominal injuries exert a significant impact on global morbidity and mortality. The aggregation of mortality data and its determinants across different regions holds immense importance for designing informed healthcare strategies. Hence, this study assessed the pooled mortality rate and its predictors across sub-Saharan Africa. Method This meta-analysis employed a comprehensive search across multiple electronic databases including PubMed, Africa Index Medicus, Science Direct, and Hinari, complemented by a search of Google Scholar. Subsequently, data were extracted into an Excel format. The compiled dataset was then exported to STATA 17 statistical software for analysis. Utilizing the Dersimonian-Laird method, a random-effect model was employed to estimate the pooled mortality rate and its associated predictors. Heterogeneity was evaluated via the I 2 test, while publication bias was assessed using a funnel plot along with Egger's, and Begg's tests. Result This meta-analysis, which includes 33 full-text studies, revealed a pooled mortality rate of 9.67% (95% CI; 7.81, 11.52) in patients with abdominal injuries across sub-Saharan Africa with substantial heterogeneity (I2 = 87.21%). This review also identified significant predictors of mortality. As a result, the presence of shock upon presentation demonstrated 6.19 times (95% CI; 3.70-10.38) higher odds of mortality, followed by ICU admission (AOR: 5.20, 95% CI; 2.38-11.38), blunt abdominal injury (AOR: 8.18, 95% CI; 4.97-13.45), post-operative complications (AOR: 8.17, 95% CI; 4.97-13.44), and the performance of damage control surgery (AOR: 4.62, 95% CI; 1.85-11.52). Conclusion Abdominal injury mortality is notably high in sub-Saharan Africa. Shock at presentation, ICU admission, blunt abdominal injury, postoperative complications, and use of damage control surgery predict mortality. Tailored strategies to address these predictors could significantly reduce deaths in the region.

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