ASSESSMENT OF MAJOR TRAUMA CLINICAL PATHWAYS AND THEIR INFLUENCE ONPATIENT OUTCOMES IN HOSPITALS WITHIN THE LAKE REGION ECONOMIC BLOCK, KENYA

Abstract

Background: Major trauma remains a leading cause of morbidity and mortality globally, particularly in low- and middle-income countries where trauma care systems are often underdeveloped. In Kenya, trauma-related injuries account for a significant proportion of emergency department admissions and hospital mortalities, driven mainly by road traffic accidents, interpersonal violence, and occupational hazards. This study aimed to assess major trauma clinical pathways and their influence on patient outcomes in hospitals within the Lake Region Economic Block, Kenya.
Methods: The study employed a quasi-experimental design with nonequivalent control and intervention groups, using a multi-stage sampling approach. A total of 220 major trauma patients were recruited in this study. A Difference-in-Differences analysis was conducted to compare changes in Intensive Care Unit (ICU) length of stay between the intervention and control groups before and after the intervention. Statistical significance was set at p < 0.05.
Results: The minimum ICU stay for both groups was 2 days, with the longest stay of 15 days recorded in the control group. The mean ICU length of stay was 3.7 days in the intervention group and 9.5 days in the control group. In addition, Patients without airway intervention had 4.58 times higher odds of admission compared to those receiving advanced airway management (aOR = 4.58, 95% CI: 1.33-15.8, p = 0.016), while Burn injuries substantially increased admission odds

Conclusion: The study demonstrated that the implementation of the Major Trauma Clinical Pathway significantly reduced ICU length of stay among trauma patients. Additionally, airway intervention and stab wounds were key predictors of ward admission. These findings highlight the importance of structured clinical pathways in improving trauma outcomes.