Elbaih Adel Hamed, Abdallah Bassant Sayed, Ismail Monira Taha
Emergency Medicine Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Afr J Emerg Med. 2023 Mar;13(1):30-36. doi: 10.1016/j.afjem.2023.01.002. Epub 2023 Jan 20.
The global prevalence of trauma-related mortality ranges from 2% to 32%; however, In Egypt, it reaches 8%. Trauma chiefly affects people in the productive age group; seriously ill patients with multiple injuries present with various levels of polytrauma. Application of incorrect triage systems and improperly trained trauma teams increase mortality and morbidity rates in non-dedicated institutions; however, these rates can decrease with appropriate infrastructure. This study aimed to improve the quality of care for patients with polytrauma through improved knowledge of the different severity levels of polytrauma and defined databases, using a suitable triage trauma system, well-trained trauma team, and appropriate infrastructure.
This observational cross-sectional study was conducted at the emergency department (ED), over a study period of 7 months, from August 10, 2019, to March 09, 2020. This study included 458 patients with polytrauma who had met the inclusion and exclusion criteria and attended the ED of Suez Canal University Hospital.
The incidence of trauma among all emergency cases in the ED was 5.3%. However, most multiple injuries are mild, accounting for 44.4%, while 27.3% of the cases had life-threatening injuries. Moreover, 41.9% of the patients were managed non-operatively, whereas 58.1% of the patients required surgical interventions. Concerning the outcome, 56% and 6.9% of patients with and without life-threatening injuries respectively, died.
Facilities of the highest quality should be available for patients with polytrauma, especially those with life-threatening injuries. In addition, training emergency medical service staff for trauma triage is essential, and at least one tertiary hospital is required in every major city in the Suez Canal and Sinai areas to decrease trauma-related mortality.
创伤相关死亡率在全球范围内为2%至32%;然而,在埃及,这一比例达到8%。创伤主要影响生产年龄组的人群;患有多处损伤的重症患者会出现不同程度的多发伤。在非专门机构中,应用不正确的分诊系统以及创伤团队培训不当会增加死亡率和发病率;然而,通过适当的基础设施,这些比率可以降低。本研究旨在通过提高对多发伤不同严重程度的认识和定义数据库,使用合适的分诊创伤系统、训练有素的创伤团队以及适当的基础设施,来改善多发伤患者的护理质量。
本观察性横断面研究于2019年8月10日至2020年3月9日在急诊科进行,为期7个月。本研究纳入了458例符合纳入和排除标准并前往苏伊士运河大学医院急诊科就诊的多发伤患者。
急诊科所有急诊病例中创伤的发生率为5.3%。然而,大多数多处损伤为轻度,占44.4%,而27.3%的病例有危及生命的损伤。此外,41.9%的患者接受非手术治疗,而58.1%的患者需要手术干预。关于结果,有危及生命损伤的患者和无危及生命损伤的患者死亡率分别为56%和6.9%。
应为多发伤患者,尤其是那些有危及生命损伤的患者提供最高质量的设施。此外,培训急诊医疗服务人员进行创伤分诊至关重要,苏伊士运河和西奈地区的每个主要城市至少需要一家三级医院,以降低创伤相关死亡率。