The Use Of A Proforma Improves The Assessment Of Spinal Cord Injury In Abuja, Nigeria

Authors:Kawu Ahidjo A , Kawu-ahidjo HO , Esenwah Vc
Int J Biol Med Res. 2011; 2(3): 679-681  |  PDF File

Abstract

Objective: To determine how the use of a proforma affects the completeness of assessment of spinal cord injured patients at the casualty of the University of Abuja Teaching Hospital Gwagwalada, Abuja. Background: Spinal cord injury (SCI) is a well documented problem. Assessment protocol of SCI has not been fully established in the casualty of most major trauma centre in Nigeria and where it is used there has not been any report of its efficacy in the literature. Our hypothesis is that proforma based assessment protocol use would improve the assessment of patients with spinal cord injury. Methods: Data on all spinal cord injured patients were prospectively documented over a 12 month period of 2009. The University of Abuja Teaching Hospital (UATH) Gwagwalada spine assessment proforma lists all items considered to be essential for a complete assessment of spinal cord injured patients in the casualty. This was then compared to the data obtained from patients admitted for spinal cord injury from 1997 to 2007 before the introduction of the proforma in December 2008. Results: Preproforma, 202 patients were assessed and 196 (97%) had one or more items missing from their reports compared to only 10/86 (11.6%) patients postproforma (p=0.001). Prehospital care, mechanism of injury, extrication, evacuation, fracture pattern, bulbocavernous reflex and standardized neurologic assessment were the items most often absent, being significantly more frequently reported after the proforma . Conclusion: Proforma based assessment protocol would help in accurate data collection and provide adequate data for informed, objective and standardized management of spinal cord injured patients.