Abhilash Kundavaram Paul Prabhakar, Chakraborthy Nilanchal, Pandian Gautham Raja, Dhanawade Vineet Subodh, Bhanu Thomas Kurien, Priya Krishna
Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2016 Jul-Sep;5(3):558-563. doi: 10.4103/2249-4863.197279.
Trauma is an increasing cause of morbidity and mortality in India. This study was done to improve the understanding of the mode of trauma, severity of injuries, and outcome of trauma victims in our hospital.
This was a retrospective observational study of all adult trauma patients more than 18-year-old presenting to our emergency department (ED). Details of the incident, injuries, and outcome were noted.
The ED attended to 16,169 patients during the 3-month study period with 10% (1624/16,169) being adult trauma incidents. The gender distribution was 73.6% males and 26.4% females. The mean age was 40.2 ± 16.7 years. The median duration from time of incident to time of arrival to the ED was 3 h (interquartile range [IQR]: 1.5-6.5) for priority one patients, 3 h (IQR: 1.5-7.7) for priority two patients, and 1.5 h (IQR: 1-7) for priority three patients. The average number of trauma incidents increased by 28% during the weekends. Road traffic accident (RTA) (65%) was the most common mode of injury, followed by fall on level ground (13.5%), fall from height (6.3%), work place injuries (6.3%), and others. Traumatic brain injury was seen in 17% of patients while 13.3% had polytrauma with two-wheeler accidents contributing to the majority. The ED team alone managed 23.4% of patients while the remaining 76.6% required evaluation and treatment by the trauma, surgical teams. The in-hospital mortality rate was 2.3%. Multivariate analysis showed low Glasgow coma score (odds ratio [OR]: 0.65, 95% confidence interval [CI]: 0.55-0.76, < 0.001) and high respiratory rate (OR: 1.15, 95% CI: 1.07-1.24, < 0.001) to be independent predictors of mortality among polytrauma victims.
RTA and falls are the predominant causes of trauma. A simple physiological variable-based scoring system such as the revised trauma score may be used to prioritize patients with polytrauma.
在印度，创伤导致的发病率和死亡率呈上升趋势。本研究旨在增进对我院创伤模式、损伤严重程度及创伤受害者结局的了解。
这是一项对所有18岁以上就诊于我院急诊科（ED）的成年创伤患者的回顾性观察研究。记录了事件、损伤及结局的详细情况。
在为期3个月的研究期间，急诊科共诊治16169例患者，其中10%（1624/16169）为成年创伤事件。性别分布为男性73.6%，女性26.4%。平均年龄为40.2±16.7岁。一级优先患者从事件发生到抵达急诊科的中位时间为3小时（四分位间距[IQR]：1.5 - 6.5），二级优先患者为3小时（IQR：1.5 - 7.7），三级优先患者为1.5小时（IQR：1 - 7）。周末创伤事件的平均数量增加了28%。道路交通事故（RTA）（65%）是最常见的受伤方式，其次是在平地上摔倒（13.5%）、高处坠落（6.3%）、工作场所受伤（6.3%）及其他。17%的患者有创伤性脑损伤，13.3%为多发伤，其中两轮摩托车事故导致的多发伤占多数。仅急诊科团队管理了23.4%的患者，其余76.6%的患者需要创伤外科团队进行评估和治疗。院内死亡率为2.3%。多因素分析显示，格拉斯哥昏迷评分低（比值比[OR]：0.65，95%置信区间[CI]：0.55 - 0.76，<0.001）和呼吸频率高（OR：1.15，95%CI：1.07 - 1.24，<0.001）是多发伤受害者死亡的独立预测因素。
道路交通事故和跌倒为创伤的主要原因。可使用如修订创伤评分这样基于简单生理变量的评分系统对多发伤患者进行优先排序。
