Pattern of admission, outcome and predictors of trauma patients visiting the surgical emergency department in comprehensive specialized hospital: a retrospective follow up study

Abstract

Background: Traumatic injuries represent huge burden in the developing world, and significant proportion has found in low- and middle-income countries. However, the pattern, outcome and factors of injury varies from setup to setup and is less studied public health problems. Objective: To assess pattern of admission, outcome and its predictors among trauma patients visiting the surgical emergency department in comprehensive specialized hospital. Methods: A retrospective follow up study was conducted and data was taken from the medical records of patients from 2019 to 2021. Simple random sampling technique was used to get a sample size of 386 from injured patient charts. Data were entered into Epi-Data version 4.6 software and exported to STATA version 14.1 for analysis. The dependent variable was injured patient’s outcome that could be died or not died. The independent variables with P-value less than 0.25 in the bi-variable regression analysis were considered for the multivariable regression. Adjusted Odds Ratio with the 95% Confidence Interval were used to declare statistical significance. Result: About 13.99% of injured patients with (95% CI: 10, 17) had died during the study period. The leading cause of injury was assault (62.44%) followed by road traffic accident (26.17%). Severe Glasgow coma scale (AOR 6.6; 95% CI: 2.6-16.4), Length of hospital stay≥7days (AOR=2.8; 95% CI: 1.2-6.2), time of arrival in between 1-24 hours (AOR=0.15; 95% CI: (0.06-0.37), and upper trunk injury (AOR=6.3; 95% CI: 1.3-28.5) were significantly associated with mortality. Conclusion and Recommendation: Mortality after traumatic injury was considerably high. Severe Glasgow coma scale, Length of hospital stay≥7days, time of arrival in between 1-24 hours, and upper trunk injury were the associated factors for mortality. Priority should be given for injured patients with decreased level of consciousness and upper trunk injury. Establishment of organized pre-hospital emergency services and provision of timely arrival is recommended. We recommend prospective follow up study.