Registry based trauma outcome: perspective of a developing country

Abstract

Objective: To report trauma outcome from a developing country based on the Trauma and Injury Severity Scoring (TRISS) method and compare the outcome with the registry data from Major Trauma Outcome Study (MTOS). Design: Registry based audit of all trauma patients over two years. Setting: Emergency room of a teaching university hospital. Subjects: 279 injured patients meeting trauma team activation criteria including all deaths in the emergency room. Outcome measures: TRISS methodology to compare expected and observed outcome. Statistical analysis: W, M, and Z statistics and comparison with MTOS data. Results: 279 patients meeting the trauma triage criteria presented to the emergency room, 235 (84.2%) were men and 44 (15.8%) women. Blunt injury accounted for 204 (73.1%) and penetrating for 75 (26.9%) patients. Seventy two patients had injury severity score of more than 15. Only 18 (6.4%) patients were transported in an ambulance. A total of 142 (50.9%) patients were transferred from other hospitals with a mean prehospital delay of 7.1 hours. M statistic of our study subset was 0.97, indicating a good match between our patients and MTOS cohort. There were 18 deaths with only one unexpected survivor. The expected number of deaths based on MTOS dataset should have been 12. Conclusions: Present injury severity instruments using MTOS coefficients do not accurately correlate with observed survival rates in a developing country.

Analysis of Prospective Trauma Registry Data in Francophone Africa: A Pilot Study from Cameroon

“…Such a trauma registry could deliver information on the cause of the injury, nature of the injury, severity, interventions delivered, and outcome [20,36]. An appropriate next step is identification of such ''core'' variables to include in a trauma registry applied in Cameroon [13,20,[38][39][40][41].…”

Pattern of trauma in a rural hospital and factors affecting mortality in trauma patients

“…[13][14][15] Most of the patients admitted with history of trauma were due to vehicular accidents (76%) followed by nonvehicular accidents i.e. fall (15.8%) and rest were due to assault (9.8%) as was seen in present study (Table 10).…”

“…[13][14][15][16] In the present study majority of patients were in young age group (16 -45 yrs) and males were the most affected. About 2/3 rd of patients belonged to age group 16 -45 yrs and 3/4 th of the patients were males.…”

“…Similar were the findings among other comparative studies showing more incidence of blunt injuries. [13][14][15] (Table 11). …”

The Role of SIGN in the Development of a Global Orthopaedic Trauma Database

“…Collecting information on the incidence, causes, treatment, and outcomes of injury cases in LMICs should therefore be a high priority. However, designing and implementing a data collection system to document the problems will not be easy, especially in LMICs [21,24,40,42]. The intended use of a database is a critical element in the design [13].…”