Epidemiology of injuries among patients admitted to Imam Khomeini Hospital, Urmia, affiliated with the national trauma registry of Iran

Abstract

Objective: Trauma is one of the major causes of mortality and morbidity globally. The current study aimed to improve the understanding of characteristics, severity of injuries and outcomes of trauma patients admitted to Imam Khomeini Hospital, Urmia, Iran. Methods: Data were obtained from the trauma registry of Imam Khomeini Hospital, a level 1 trauma referral center, for all patients admitted to the center from 17 september 2016 to 21 January 2023. Patients’ demographics, injury mechanisms, and patients' outcomes were analyzed. Results: The emergency department attended to 5555 trauma patients. The gender distribution was with 3998 (71.9%) males and 1557 (29.1%) females. Patients' age ranged from 1 to 101 years, with a mean±standard deviation (SD) of 33.1 (±20.7) years. Road traffic accidents followed by falls were the most common causes of traumas reported in 2138 (38.5%) and 1298 (23.4%) trauma patients, respectively. The in-hospital mortality rate was 0.9% (53 patients). The mean (±SD) age of death was 43.5 (±22.4) years. 569 (10.2%) patients were admitted to the intensive care unit (ICU). The univariable logistic regression models showed that there were significant associations between age (P<0.001), Glasgow coma scale (GCS) (P<0.001), injury severity score (ISS) (P<0.001), and mechanical ventilation (P<0.001) as independent variables and death outcome. The univariable and multiple logistic regression analyses showed statistically significant associations between age, cause of trauma, ISS, GCS and body site injury with ICU admission. The odds of ICU admission in patients after being adjusted for age, ISS, GCS, cause of trauma and type of transportation was 1.73 times higher in head, face, and neck injuries compared to limb injuries.  (adjusted OR: 1.73, [95% CI: 1.23,2.42]; P<0.01). Conclusion: Older age, low GCS, higher ISS and mechanical ventilation were associated with higher mortality. Older age, higher ISS, lower GCS, body site injury, type of transportation, and cause of trauma were all significant independent predictors of ICU admission.

Injuries: World health organization (WHO). Available from: https://www.who.int/teams/integrated-health-services/clinical-services-and-systems/surgical-care/injuries.

Injuries and violence: World health organization (WHO) 2021. Available from: : https://www.who.int/news-room/fact-sheets/detail/injuries-and-violence.

Forouzanfar MH, Sepanlou SG, Shahraz S, et al. Evaluating causes of death and morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010. Arch Iran Med. 2014;17(5):304-20.

World Health Organization. Global status report on road safety 2018 [Internet]. Available from: https://www.afro.who.int/publications/global-status-report-road-safety-time-action.

Global Burden of Disease (GBD). Available from: https://vizhub.healthdata.org/gbd-compare/.

. Gabbe BJ, Simpson PM, Sutherland AM, et al. Improved functional outcomes for major trauma patients in a regionalized, inclusive trauma system. Ann Surg. 2012;255(6):1009-15.

Organization WH. Guidelines for essential trauma care: World health organization; 2004.

Organization WH. Guidelines for trauma quality improvement programmes: world health organization; 2009.

Organization WH. Global launch: decade of action for road safety 2011-2020. World health organization; 2011.

Cameron PA, Gabbe BJ, Cooper DJ, Walker T, Judson R, McNeil J. A statewide system of trauma care in Victoria: effect on patient survival. Med J Aust. 2008;189(10):546-50.

O’Reilly GM, Cameron PA, Joshipura M. Global trauma registry mapping: a scoping review. Injury. 2012;43(7):1148-53.

Mobinizadeh M, Berenjian F, Mohamadi E, Habibi F, Olyaeemanesh A, Zendedel K, et al. Trauma registry data as a policy-making tool: a systematic review on the research dimensions. Bull Emerg Trauma. 2022;10(2):49.

Gabbe BJ, Lyons RA, Fitzgerald MC, Judson R, Richardson J, Cameron PA. Reduced population burden of road transport–related major trauma after introduction of an inclusive trauma system. Ann Surg. 2015;261(3):565.

Stevenson M, Segui-Gomez M, Lescohier I, Di Scala C, McDonald-Smith G. An overview of the injury severity score and the new injury severity score. Inj Prev. 2001;7(1):10-3.

Sharif-Alhoseini M, Zafarghandi M, Rahimi-Movaghar V, Heidari Z, Naghdi K, Bahrami S, et al. National trauma registry of Iran: a pilot phase at a major trauma center in Tehran. Arch Iran Med. 2019;22(6).

Ghodsi Z, Movaghar VR, Zafarghandi M, Saadat S, Mohammadzadeh M, Fazel M, et al. The minimum dataset and inclusion criteria for the national trauma registry of Iran: a qualitative study. Archives of Trauma Research. 2017;6(2):7.

Bigdeli M, Khorasani-Zavareh D, Mohammadi R. Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study. BMC public health. 2010;10:1-7.

Saberian L, Baigi V, Zafarghandi M, Naghdi K, Ozlaty M, Bahrami S, et al. Gender-based trauma outcomes and predictors of postinjury in-hospital mortalities: A multicenter analysis from the national trauma registry of Iran. Archives of Trauma Research. 2021;10(4):209-14.

Khaleghi-Nekou M, Moradi A, Zafarghandi M, Fayaz-Bakhsh A, Saeednejad M, Rahimi-Movaghar V, et al. Epidemiology of fatal injuries among patients admitted at Sina hospital, the national trauma registry of Iran, 2016-2019. Front Emerg Med. 2021;5(1):e9-e.

Saeednejad M, Zafarghandi M, Khalili N, Baigi V, Khormali M, Ghodsi Z, et al. Evaluating mechanism and severity of injuries among trauma patients admitted to Sina Hospital, the national trauma registry of Iran. Chin J of Traumatol. 2021;24(03):153-8.

Zuercher M, Ummenhofer W, Baltussen A, Walder B. The use of Glasgow coma scale in injury assessment: a critical review. Brain Inj. 2009;23(5):371-84.

Butcher NE, Enninghorst N, Sisak K, Balogh ZJ. The definition of polytrauma: variable interrater versus intrarater agreement—a prospective international study among trauma surgeons. J Trauma Acute Care Surg. 2013;74(3):884-9.

Bolandparvaz S, Yadollahi M, Abbasi HR, Anvar M. Injury patterns among various age and gender groups of trauma patients in southern Iran: a cross-sectional study. Medicine. 2017;96(41).

Macleod JB, Lynn M, Mckenney MG, Jeroukhimov I, Cohn SM. Predictors of mortality in trauma patients. The Am Surg. 2004;70(9):805-10.

Johnson NJ, Carr BG, Salhi R, Holena DN, Wolff C, Band RA. Characteristics and outcomes of injured patients presenting by private vehicle in a state trauma system. Am J Emerg Med. 2013;31(2):275-81.

Gold CR. Prehospital advanced life support vs “scoop and run” in trauma management. Ann Emerg Med. 1987;16(7):797-801.

Newgard CD, Schmicker RH, Hedges JR, Trickett JP, Davis DP, Bulger EM, et al. Emergency medical services intervals and survival in trauma: assessment of the “golden hour” in a North American prospective cohort. Ann Emerg Med. 2010;55(3):235-46. e4.

Stiell IG, Nesbitt LP, Pickett W, Munkley D, Spaite DW, Banek J, et al. The OPALS major trauma study: impact of advanced life-support on survival and morbidity. Cmaj. 2008;178(9):1141-52.

Carr BG, Caplan JM, Pryor JP, Branas CC. A meta-analysis of prehospital care times for trauma. Prehosp Emerg Care. 2006;10(2):198-206.

Wandling MW, Nathens AB, Shapiro MB, Haut ER. Association of prehospital mode of transport with mortality in penetrating trauma: a trauma system–level assessment of private vehicle transportation vs ground emergency medical services. JAMA surgery. 2018;153(2):107-13.

Zafar SN, Haider AH, Stevens KA, Ray-Mazumder N, Kisat MT, Schneider EB, et al. Increased mortality associated with EMS transport of gunshot wound victims when compared to private vehicle transport. Injury. 2014;45(9):1320-6.

Demetriades D, Chan L, Cornwell E, Belzberg H, Berne TV, Asensio J, et al. Paramedic vs private transportation of trauma patients: effect on outcome. Arch Surg. 1996;131(2):133-8.

Band RA, Pryor JP, Gaieski DF, Dickinson ET, Cummings D, Carr BG. Injury‐adjusted mortality of patients transported by police following penetrating trauma. Acad Emerg Med. 2011;18(1):32-7.

Cornwell EE, Belzberg H, Hennigan K, Maxson C, Montoya G, Rosenbluth A, et al. Emergency medical services (EMS) vs non-EMS transport of critically injured patients: a prospective evaluation. Arch Surg. 2000;135(3):315-9.

Al-Shaqsi S, Al-Kashmiri A, Al-Hajri H, Al-Harthy A. Emergency medical services versus private transport of trauma patients in the Sultanate of Oman: a retrospective audit at the Sultan Qaboos University Hospital. Emerg Med J. 2014;31(9):754-7.

Liberman M, Mulder D, Lavoie A, Denis R, Sampalis JS. Multicenter Canadian study of prehospital trauma care. Ann Surg. 2003;237(2):153.

Liberman M, Mulder D, Sampalis J. Advanced or basic life support for trauma: meta-analysis and critical review of the literature. J Trauma. 2000;49(4):584-99.

Eckstein M, Chan L, Schneir A, Palmer R. Effect of prehospital advanced life support on outcomes of major trauma patients. J Trauma . 2000;48(4):643-8.

Feero S, Hedges JR, Simmons E, Irwin L. Does out-of-hospital EMS time affect trauma survival? Am J Emerg Med. 1995;13(2):133-5.

Sampalis JS, Lavoie A, Williams J, Mulder DS, Kalina M. Impact of on-site care, prehospital time, and level of in-hospital care on survival in severely injured patients. J Trauma. 1993;34(2):252-61.

Haut ER, Kalish BT, Cotton BA, Efron DT, Haider AH, Stevens KA, et al. Prehospital intravenous fluid administration is associated with higher mortality in trauma patients: a national trauma data bank analysis. Ann Surg. 2011;253(2):371-7.

Files
IssueVol 8 No 1 (2024): Winter (February) QRcode
SectionOriginal article
DOI 10.18502/fem.v8i1.14893
Keywords
National Trauma Registry of Iran Registry Trauma

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Hassan Zadeh Tabatabaei MS, Baigi V, Zafarghandi M, Rahimi-Movaghar V, Valizade Hasanloei MA, Piri SM, Khavandegar A, Naghdi K, Salamati P. Epidemiology of injuries among patients admitted to Imam Khomeini Hospital, Urmia, affiliated with the national trauma registry of Iran. Front Emerg Med. 2024;8(1):e5.

Downloads

Download data is not yet available.