title: Prehospital transport of spinal cord-injured patients in Nigeria.
abstract: BACKGROUND
  Well-organised and efficient prehospital transport is associated with an improved outcome in trauma patients. In Nigeria there is a paucity of information on prehospital transport of spinal cord-injured patients and its relation to mortality.
  
  
  OBJECTIVE
  To determine whether prehospital transportation is a predictor of mortality in spinal cord-injured patients in Nigeria.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Prehospital transport-related conditions, injury-to-arrival intervals and persons who brought spinal cord-injured patients to the casualty departments at the University of Abuja Teaching Hospital, Gwagwalada, and the National Orthopaedic Hospital, Lagos, were noted. Data were analysed using descriptive statistics, the chi-square test and multiple logistic regressions.
  
  
  METHODS
  Mortality within 6 weeks of admission. Results. During the review period, 168 patients with spinal cord injury presented to the casualty departments. Most presented 24 hours or more after the injury (67.9%) and were brought to casualty by their relatives (58.3%). Saloon cars were the most common mode of transportation (54.2%), most patients (55.4%) lying on their back during transfer. The majority of the patients (75%) had been taken to at least one other hospital before arriving at our casualty departments. The mortality rate was 16.7%. Multivariate analysis after adjusting for age, gender and means of transportation revealed that age (odds ratio (OR) 63.41, 95% confidence interval (CI) 9.24 - 43.53), a crouched position during transfer (OR 23.52, 95% CI 7.26 - 74.53), presentation after 24 hours (OR 5.48, 95% CI 3.20 - 16.42) and multiple hospital presentations (OR 7.94, 95% CI 1.89 - 33.43) were associated with death within 6 weeks of admission.
  
  
  CONCLUSIONS
  Well-organised and efficient prehospital transport would reduce mortality in spinal cord-injured patients. Providing information on prehospital transport would also reduce mortality.
authors.affiliation: University of Abuja Teaching Hospital, Federal Capital Territory, Gwagwalada, Nigeria. ahidjokawu@yahoo.com
authors.forename: Kawu A
authors.initials: KA
authors.lastname: Ahidjo
authors.forename: Salami A
authors.initials: SA
authors.lastname: Olayinka
authors.forename: Olawepo
authors.initials: O
authors.lastname: Ayokunle
authors.forename: Alimi F
authors.initials: AF
authors.lastname: Mustapha
authors.forename: Gbadegesin A A
authors.initials: GA
authors.lastname: Sulaiman
authors.forename: Adebule T
authors.initials: AT
authors.lastname: Gbolahan
mesh_terms: D006801:Humans; D015999:Multivariate Analysis; D009549:Nigeria; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000401:mortality*; D014187:Transportation of Patients; D016896:Treatment Outcome