Urban injuries in Tehran: demography of trauma patients and evaluation of trauma care.

Trauma now attracts more attention than ever before as a major cause of death and disability in developed and developing countries. To describe the characteristics and outcome of injuries in our environment, and to identify and discuss possible preventative and management protocols that may also be adopted in developing countries, we designed a prospective study on all trauma patients consecutively attending three emergency departments over a period of 1 year in Tehran, Iran. Among the total of 58013 patients studied, workers were the most vulnerable occupational group and deserve special preventative measures. The high frequency of traffic (especially pedestrian) accidents suggests that considerable progress is required in preventing these injuries. Our hospitalized patients were comparable with patients in the Major Trauma Outcome Study (m=0.890), and the z (-15.485) and w (-2.447) statistics showed an unsatisfactory quality of care, which may partly be due to less usage of ambulances, the long time of transportation to hospital, frequent referrals between centres, and delayed and inadequate resuscitation by the emergency services. Based on our findings and the fact that the positive effect of trauma systems on outcome has been well documented, we suggest that an integrated trauma system be established in Tehran to improve the quality of trauma care.