Trauma Severity Scoring and its immediate outcome Measure among Patients with Trauma incident attending by Emergency Medical Services, the case of Tikur Anbessa and Yekatit12 Hospitals.
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Date
2010-08
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Addis Abeba University
Abstract
Trauma is the leading cause of morbidity and mortality all over the world Trauma can be a threat to life through damaging different body part that involve the most active group of society and can result in prolonged compensation.The severity of trauma and immediate outcome of trauma measure can enable to evaluate health care intervention for an emergency trauma patient.In this research, retrospective patient care record review design is used for trauma patients who attended the emergency department of Tikur Anbessa and Yekatit 12 Hospital. The research is conducted from August 2009 to June 2010, and the record review and data collection period was from March to April 2010. All identified trauma patient care record about patient with altered level of consciousness who attend emergency medical service throughout the previous year and those who fulfill inclusion criteria was reviewed. Data was analyzed using SPSS 15.0 statistical package.Indescriptive statistic frequency, median, and standard deviations were computed. The TRISS methodology was used to score trauma severity and to compare the data outcome.
Among 328 trauma patients 72.9% were males and 27.1% were female. The median age was 30 years. 86.0 of them were below 54 years. From the total patient care record review the median of ISS and RTS were 25 and 7.84 with range 16 – 75 and 0.00 – 7.84 , and standard deviation of 12.60 and 1.54 respectively. Sustained penetrating trauma were accounted for 30(9.1%) of the total trauma incidents and sustained blunt trauma were accounted for 298(90.9%) of total trauma incidents. The majority of the trauma patients (49%) were sustained road traffic accident followed by strike by blunt object (18%)and fall > 5 meter (15%). Out of the total 328 trauma patients 18.3 % of them were died. The area under the curve at the ROC analysis was 0.967 for TRISS, 0.127 for ISS, and 0.903 for RTS (P < 0.0001 for each). Regarding actual survival status against TRISS, the use of a cut-off point of greater than 67.3 provided a sensitivity of 97.39% and a specificity of 65%. The overall severity rate, mortality rate and Hospital length of stay were higher in these two Hospitals with larger involvement of young adult and male. Head and groin region accident was more commonly altered anatomical region.
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Keywords
Trauma incident, Trauma scoring, Trauma outcome