The Hybrid Electronic Medical Registry Allows Benchmarking of Quality of Trauma Care: A Five-Year Temporal Overview of the Trauma Burden at a Major Trauma Centre in South Africa

  • M. M. DonovanEmail author
  • V. Y. Kong
  • J. L. Bruce
  • G. L. Laing
  • W. Bekker
  • V. Manchev
  • M. Smith
  • D. L. Clarke
Original Scientific Report



This study is a five-year follow-up of previously published review of the trauma workload at our institution. It aims to provide evidence about the quality of trauma care delivered by a major academic trauma service in South Africa to provide a temporal analysis of trauma trends in the city of Pietermaritzburg.

Materials and methods

All trauma patients admitted by the Pietermaritzburg Metropolitan Trauma Service (PMTS) for the period December 2012-April 2018 were retrieved from the Hybrid Electronic Medical Registry (HEMR) for analysis.


Over the five-year period, a total of 8722 trauma patients were admitted to Grey’s Hospital. There were 7242 (83.0%) males. The average age was 29.66 years. A total of 1719 (19.7%) patients less than 19 years of age, 377 (4.3%) older than 60 years of age and 1480 (17.0%) female patients were admitted following trauma. Table 3 breaks down the mechanism of trauma. A total of 5027 patients sustained blunt trauma (57.6%), and 3334 (38.5%) sustained penetrating trauma. A total of 4808 patients sustained intentional trauma implying that 55.1% of all trauma was secondary to grievous bodily harm or assault either in the form of a stab wound or GSW or of an assault. There was a total of 2232 road traffic-related incidents, of which 37.9% (845) were pedestrian victims. The mortality rate for all trauma admissions was 4.5% (396). Of these 396 deaths, 64 (16.2%) were classified at the morbidity and mortality conference as being avoidable.


The HEMR has allowed us to track the burden of trauma presenting to our institution over a five-year period. This confirms previous studies over shorter time periods from our institution. The pattern of trauma has remained consistent, and the previously described high levels show no sign of decreasing. Interventions to try and reduce this burden are urgently required.


Compliance with ethical standards

Conflicts of interest

All authors declare that they have no conflicts of interest

Ethical approval

Ethics approval for this study and for maintenance of the registry was formally endorsed by the Biomedical Research Ethics Committee (BREC) of the University of Kwa-Zulu Natal (reference: BE 207/09).


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • M. M. Donovan
    • 1
    Email author
  • V. Y. Kong
    • 2
    • 3
  • J. L. Bruce
    • 3
  • G. L. Laing
    • 3
  • W. Bekker
    • 3
  • V. Manchev
    • 3
  • M. Smith
    • 3
  • D. L. Clarke
    • 3
  1. 1.Stanford University School of MedicineStanfordUSA
  2. 2.Department of SurgeryUniversity of the WitwatersrandJohannesburgSouth Africa
  3. 3.Department of SurgeryUniversity of Kwa-Zulu NatalDurbanSouth Africa

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