Using the Patient Data in the Hualien Earthquake to Analyze the Reasons of Visit, the Trauma Injury Sites and the Severity

Abstract

Introduction:On February 6, 2018, a magnitude 6.2 earthquake struck Hualien, the eastern part of Taiwan. The quake resulted in 17 deaths and more than 300 people injured. Four buildings completely collapsed and hundreds of houses were damaged.Aim:The aim of this research was to use the patient data to analyze the reasons for visits, the trauma sites, and the severity.Methods:We obtained the patient information from the Taiwan Eastern Medical Emergency Operation Center. Medical records were reviewed to analyze the primary diagnosis, the trauma mechanisms, and the sites of injury. Injury severity score (ISS) was used to assess trauma severity.Results:Two hundred and eighty patients were included in the study, with 90.3% being traumatic patients. Among them, 18.2% was geriatric trauma, 4.7% was pediatric trauma, and 0.4% was obstetric trauma. The most common injury site was lower extremities (33.2%), followed by head (31.4%) and upper extremities (27.1%). The mean injury severity score (ISS) was 1.9. The geriatric population had an average ISS of 2.4, and the pediatric group had a mean ISS of 1.2.Discussion:In our study, the majority of the patients had minor trauma. Lower extremities may be more vulnerable during the evacuation of an earthquake, and thus, became the most common injury site. The elderly patients had a higher ISS, which may be explained by their immobility and fragility of the body. In the future, it is critical to educate citizens about self-protection during earthquakes, focusing on protecting the head and the extremities. Healthcare providers and emergency medical technicians need to be well-trained to handle geriatric trauma since it poses unique challenges and is associated with increased mortality.

Related Factors Associated With Earthquake Inpatient Mortality

“…Using the available information from the West China Earthquake Patients Database, we collected data on 12 dichotomous variables with reference to previous reports, [1][2][3][4][5][6][7][8][9][10][11] which we labeled: pediatric patient, geriatric patient, gender, prehospital treatment, ICU admission, severe TBI, trunk injury, severe poly-trauma, crush syndrome, MSOF, infection, and cardiac/respiratory disease. We defined these dichotomous variables as follows: (1) Pediatric patient means a patient younger than or equal to 15 years old; (2) Geriatric patient means a patient older than or equal to 65 years old; (3) Gender means whether the patient was male or female; (4) Prehospital treatment means that the earthquake patient received primary medical treatment by health-care providers before being transferred to any hospital; (5) ICU admission means that the patient was admitted to the ICU, including adult ICU, neonatal ICU, pediatric ICU, or other intensive care wards, while hospitalized; (6) Severe TBI was defined as a single head injury resulting from an external mechanical force due to the earthquake, along with a Glasgow Coma Score of 8 or below 1 ; (7) Trunk injury was defined as a single chest or abdomen injury, judged by radiological examination (eg, a computed tomography scan or magnetic resonance imaging); (8) Severe poly-trauma means that more than 1 anatomical area or organ is severely traumatized, with an Injury Severe Score (ISS) greater than or equal to 15 points; (9) Crush syndrome refers to a severe shock-like condition that follows the release of a large body part, such as a limb, after a prolonged period of mechanical compression.…”

“…1 Previous studies have discussed different related factors of earthquake inpatient mortalities. These studies each analyzed 1 or 2 different related factors, such as young age (≤15 years), 2 old age (≥65 years), 3,4 gender, 5 prehospital treatment, 6 and admission to an intensive care unit (ICU). 2 Additional related factors include the presence of a severe traumatic brain injury (TBI), 1 trunk injury, 6,7 severe poly-trauma, 8 crush syndrome, 9 multiple-system organ failure (MSOF), 1 infection, 1 or cardiac/ respiratory disease.…”