Blunt Abdominal Trauma in Geriatric Populations in a Rural Nigerian Community: Clinical Outcomes, Socioeconomic Barriers, and Systemic Challenges
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2025
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| author | Umezurike, DAH |
| author_facet | Umezurike, DAH |
| contents | <div><span>ABSTRACT</span></div> <div><span>Geriatric populations in rural Nigeria face disproportionately high risks from blunt abdominal trauma (BAT) due to </span><span>physiological fragility, limited healthcare access, and socioeconomic marginalization. This retrospective cohort study </span><span>analyzed 32 patients aged >65 years admitted with BAT at Alex Ekwueme Federal University Teaching Hospital </span><span>(AEFUTHA), Abakaliki, a referral center for southeastern Nigeria's agrarian communities, where geriatric patients </span><span>accounted for 32.1% of all BAT cases over a two-year period (2022–2023). Data on demographics, injury mechanisms, </span><span>clinical management, and outcomes were extracted from hospital records and analyzed using SPSS v28. The cohort </span><span>(median age: 73 years, IQR: 68–79) was predominantly male (65.6%, n=21) and engaged in subsistence farming </span><span>(81.3%, n=26). Falls (40.6%, n=13), assaults (25.0%, n=8), and road crashes (18.8%, n=6) were the primary injury </span><span>mechanisms. Delayed hospital presentation (>24 hours) occurred in 84.4% (n=27) of cases, with 53.1% (n=17) initially </span><span>seeking traditional healers. Clinically, 68.8% (n=22) presented with baseline anemia (Hb <8 g/dL), and 43.8% (n=14) </span><span>exhibited hemodynamic instability (SBP <90 mmHg). Hollow viscus perforations (34.4%, n=11) and hepatic/splenic </span><span>injuries (28.1%, n=9) predominated. All patients required laparotomy, but 87.5% (n=28) experienced surgical delays </span><span>(>24 hours post-admission) due to financial constraints. Mortality reached 37.5% (n=12), primarily from sepsis </span><span>(75.0%, n=9). Catastrophic health expenditure (CHE) affected 96.9% (n=31) of families, with 59.4% (n=19) selling </span><span>livestock to fund care. Geriatric mortality quadrupled adult rates (37.5% vs. 9.4%), with multivariate logistic regression </span><span>identifying baseline anemia (OR: 3.8), surgical delays (OR: 4.1), and CHE (OR: 2.7) as independent predictors. These </span><span>findings underscore systemic failures in prehospital care, diagnostic delays, and financial toxicity as key drivers of </span></div> <div><span>preventable geriatric trauma deaths in rural Nigeria. Urgent interventions—including subsidized trauma insurance, </span><span>community-based fall prevention programs, and task-shifting ultrasound training for rural clinicians—are needed to </span><span>mitigate disparities and align with global health equity goals.</span></div> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_15766484 |
| institution | Zenodo |
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| publishDate | 2025 |
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| spellingShingle | Blunt Abdominal Trauma in Geriatric Populations in a Rural Nigerian Community: Clinical Outcomes, Socioeconomic Barriers, and Systemic Challenges Umezurike, DAH Blunt abdominal trauma, Catastrophic health expenditure, Geriatric trauma, Health equity, Rural Nigeria, Sepsis, Surgical delays <div><span>ABSTRACT</span></div> <div><span>Geriatric populations in rural Nigeria face disproportionately high risks from blunt abdominal trauma (BAT) due to </span><span>physiological fragility, limited healthcare access, and socioeconomic marginalization. This retrospective cohort study </span><span>analyzed 32 patients aged >65 years admitted with BAT at Alex Ekwueme Federal University Teaching Hospital </span><span>(AEFUTHA), Abakaliki, a referral center for southeastern Nigeria's agrarian communities, where geriatric patients </span><span>accounted for 32.1% of all BAT cases over a two-year period (2022–2023). Data on demographics, injury mechanisms, </span><span>clinical management, and outcomes were extracted from hospital records and analyzed using SPSS v28. The cohort </span><span>(median age: 73 years, IQR: 68–79) was predominantly male (65.6%, n=21) and engaged in subsistence farming </span><span>(81.3%, n=26). Falls (40.6%, n=13), assaults (25.0%, n=8), and road crashes (18.8%, n=6) were the primary injury </span><span>mechanisms. Delayed hospital presentation (>24 hours) occurred in 84.4% (n=27) of cases, with 53.1% (n=17) initially </span><span>seeking traditional healers. Clinically, 68.8% (n=22) presented with baseline anemia (Hb <8 g/dL), and 43.8% (n=14) </span><span>exhibited hemodynamic instability (SBP <90 mmHg). Hollow viscus perforations (34.4%, n=11) and hepatic/splenic </span><span>injuries (28.1%, n=9) predominated. All patients required laparotomy, but 87.5% (n=28) experienced surgical delays </span><span>(>24 hours post-admission) due to financial constraints. Mortality reached 37.5% (n=12), primarily from sepsis </span><span>(75.0%, n=9). Catastrophic health expenditure (CHE) affected 96.9% (n=31) of families, with 59.4% (n=19) selling </span><span>livestock to fund care. Geriatric mortality quadrupled adult rates (37.5% vs. 9.4%), with multivariate logistic regression </span><span>identifying baseline anemia (OR: 3.8), surgical delays (OR: 4.1), and CHE (OR: 2.7) as independent predictors. These </span><span>findings underscore systemic failures in prehospital care, diagnostic delays, and financial toxicity as key drivers of </span></div> <div><span>preventable geriatric trauma deaths in rural Nigeria. Urgent interventions—including subsidized trauma insurance, </span><span>community-based fall prevention programs, and task-shifting ultrasound training for rural clinicians—are needed to </span><span>mitigate disparities and align with global health equity goals.</span></div> |
| title | Blunt Abdominal Trauma in Geriatric Populations in a Rural Nigerian Community: Clinical Outcomes, Socioeconomic Barriers, and Systemic Challenges |
| topic | Blunt abdominal trauma, Catastrophic health expenditure, Geriatric trauma, Health equity, Rural Nigeria, Sepsis, Surgical delays |
| url | https://doi.org/10.5281/zenodo.15766484 |