A cohort analysis of Pamukkale University Medical Faculty Emergency Department trauma cases

Abstract

Objectives: Trauma is one of the most important reasons of morbidity and mortality among young adults. In this study we aimed to describe the demographic and clinical characteristics of trauma patients admitted to our emergency department. We evaluated their length of stay in emergency department and inpatient service. We also assessed the factors for morbidity and mortality and their relation with trauma scores. Our purpose was contribution to trauma data in our country.

Materials and Methods: All patients admitted for trauma to emergency department of Pamukkale University Medical Faculty between 01.01.2006 and 31.06.2006 were included in this prospective study. The age, sex, mechanism of trauma, time of trauma, transportation type and time to the emergency department, area of trauma, procedures for the trauma, time of stay in hospital and trauma scores (Glaskow Coma Score, Abbreviated Injury Scale, and Injury Severity Score (ISS)) were noted to the special forms prepared before. Later, demographic characteristics and trauma scores were analyzed for the outcome of patients.

Results: Approximately 6000 patients admitted to our emergency department during these 6 months period. Among these patients 563 (9.4%) who were admitted for trauma were included in the study. Children and adults constituted 15.1% and 84.9% of the patients respectively. Among adults, 70.5% were males and 5.2% were >= 65 years. Types of transportation to ED were; 55.6% with private vehicles, 38.5% were with ambulances. Types of trauma were; 33.7% traffic accidents, 30.7% falls, 15.5% accidents at a work place, and 11.4% knife and gun shots. The mean time periods for the stay in the emergency department and inpatient service of the hospital were 5.04 +/- 6.55 hours and 4.18 +/- 2.81 days, respectively. The most common area of trauma was upper extremity (both in adults and children) and the most common service admission was orthopedic service. Admission to the hospital was 23.3%, referral to another hospital was 2.7%, and mortality rate was 1.9%. 73.2% of patients were discharged from emergency department and 22.2% discharged from the inpatient service. The mean ISS scores (+/- SD) were 6.23 +/- 7.89 for adults and 4.54 +/- 5.93 for children. 90.6% of patients had <16 ISS scores and 9.4% of patients had >= 16 ISS scores.

Conclusion: Frequent causes of the traumas were traffic accidents and falls. The most common mechanism was blunt trauma. Both among adults and children upper and lower extremities were the most common area of the injury. Injury severity score and age were predictors for mortality and morbidity.