Sabariah F J, Ramesh N, Mahathar A W
Emergency Department, Sungai Buloh Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
Med J Malaysia. 2008 Sep;63 Suppl C:45-9.
The first Malaysian National Trauma Database was launched in May 2006 with five tertiary referral centres to determine the fundamental data on major trauma, subsequently to evaluate the major trauma management and to come up with guidelines for improved trauma care. A prospective study, using standardized and validated questionnaires, was carried out from May 2006 till April 2007 for all cases admitted and referred to the participating hospitals. During the one year period, 123,916 trauma patients were registered, of which 933 (0.75%) were classified as major trauma. Patients with blunt injury made up for 83.9% of cases and RTA accounted for 72.6% of injuries with 64.9% involving motorcyclist and pillion rider. 42.8% had severe head injury with an admission Glasgow Coma Scale (GCS) of 3-8 and the Revised Trauma Score (RTS) of 5-6 were recorded in 28.8% of patients. The distribution of Injury Severity Score (ISS) showed that 42.9% of cases were in the range of 16-24. Only 1.9% and 6.3% of the patients were reviewed by the Emergency Physician and Surgeon respectively. Patients with admission systolic blood pressure of less than 90 mmHg had a death rate of 54.6%. Patients with severe head injury (GCS < 9), 45.1% died while 79% patients with moderate head injury survived. There were more survivors within the higher RTS range compared to the lower RTS. Patients with direct admission accounted for 52.3% of survivors and there were 61.7% survivors for referred cases. In conclusion, NTrD first report has successfully demonstrated its significance in giving essential data on major trauma in Malaysia, however further expansion of the study may reflect more comprehensive trauma database in this country.
首个马来西亚国家创伤数据库于2006年5月启用，涉及五个三级转诊中心，旨在确定重大创伤的基础数据，随后评估重大创伤的管理情况，并制定改善创伤护理的指南。2006年5月至2007年4月，对所有入住和转诊至参与医院的病例进行了一项前瞻性研究，采用标准化且经过验证的问卷。在这一年期间，登记了123,916名创伤患者，其中933名（0.75%）被归类为重大创伤。钝性损伤患者占病例的83.9%，道路交通伤占损伤的72.6%，其中64.9%涉及摩托车骑手和乘客。42.8%的患者有严重颅脑损伤，入院时格拉斯哥昏迷量表（GCS）评分为3 - 8分，28.8%的患者记录了修订创伤评分（RTS）为5 - 6分。损伤严重程度评分（ISS）分布显示，42.9%的病例在16 - 24分范围内。分别只有1.9%和6.3%的患者接受了急诊医生和外科医生的检查。入院收缩压低于90 mmHg的患者死亡率为54.6%。严重颅脑损伤（GCS < 9）的患者，45.1%死亡，而中度颅脑损伤的患者79%存活。与较低RTS范围相比，较高RTS范围内的幸存者更多。直接入院的患者占幸存者的52.3%，转诊病例的幸存者为61.7%。总之，国家创伤数据库的首次报告成功证明了其在提供马来西亚重大创伤基本数据方面的重要性，然而该研究的进一步扩展可能会反映该国更全面的创伤数据库。
