Epidemiological Features of Injured Patients Examined by Tehran Emergency Medical Service Technicians
Abstract
Introduction: Knowledge of epidemiological aspects can be a useful guide in determining the resources for better prevention and management of injuries. There are some performed studies on this topic in Iran, based on the limited hospital database. However, to the best of our knowledge, there is not any survey based on the pre-hospital database. Objective: The purpose of this study was to assess baseline characteristics of the traumatic patients according to the records of Tehran Emergency Medical Service (EMS) Center to present descriptive statistics of their epidemiological features. Method: This cross-sectional study was conducted retrospectively, using Tehran EMS center data registry. All traumatic patients examined by EMS in Tehran, Iran following call to emergency medical dispatcher were included. By reviewing the EMS technicians’ mission forms, required data were extracted. The mission form contains information such as age, sex, injured location, damage mechanism, accident location (home, workplace, street), time of call, the outcome of the patient's ambulance mission and the results of the assessment of the technician, etc. Results: Totally, 56612 injured cases with the mean age of 33.1±15.6 years were examined by EMS during one-year study period of whom 80.4% were male. Crude Incidence Rate was 10.5 and 2.5 per 1000 in male and female, respectively. Traffic accident and then fall were the two most prevalent mechanism of injuries. All types of injuries were significantly more prevalent in males (P<0.001). Most injuries were in winter season with 15570 cases (27.5%). Car accident was prevalent in winter and other injuries were significantly prevalent in spring (P<0.001). The most frequent places of injuries occurred on main roads and streets (55.7%). All of the road-related injuries was prevalent in winter, whereas injuries in other places were prevalent in spring (P<0.001). Most of the cases (78.3%) were transferred to the health centers, but 20.7% did not consent to treatment and transmission. Only 222 cases (0.4%) died, that 95% was due to traffic accident. there was a significant relationship between the number of injured organs and the death; So that the highest death rate occurred for those with more than 5 injured organs (P <0.001). Conclusion: Based on the findings, traffic accident was the most frequent cause of trauma that led to visiting a traumatic patient by an EMS technician in Tehran, Iran. Injuries in all age groups were more prevalent in males, and the involvement of 5 or more injured organ had a significant relationship with mortality.
2. Krug EG, Sharma GK, Lozano R. The global burden of injuries. Am J Public Health. 2000;90(4):523-6.
3. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997;349(9064):1498-504.
4. Safari S, Baratloo A, Negida AS, Taheri MS, Hashemi B, Selkisari SH. Comparing the interpretation of traumatic chest X-ray by emergency medicine specialists and radiologists. Arch Trauma Res. 2014;3(4):e22189.
5. Safari S, Radfar F, Baratloo A. Thoracic injury rule out criteria and NEXUS chest in predicting the risk of traumatic intra-thoracic injuries: A diagnostic accuracy study. Injury. 2018;49(5):959-62.
6. van Beeck EF, van Roijen L, Mackenbach JP. Medical costs and economic production losses due to injuries in the Netherlands. J Trauma. 1997;42(6):1116-23.
7. Bastida JL, Aguilar PS, Gonzalez BD. The economic costs of traffic accidents in Spain. J Trauma. 2004;56(4):883-8.
8. Rahmati F, Doosti M, Bahreini M. The Cost Analysis of Patients with Traffic Traumatic Injuries Presenting to Emergency Department; a Cross-sectional Study. Adv J Emerg Med. 2018;3(1):e2.
9. Fazel MR, Fakharian E, Mahdian M, Mohammadzadeh M, Salehfard L, Ramezani M. Demographic Profiles of Adult Trauma During a 5 Year Period (2007-2011) in Kashan, IR Iran. Arch Trauma Res. 2012;1(2):63-6.
10. Ramouz A, Hosseini M, Shams-Vahdati S. Epidemiology of head and neck fractures caused by motorcycle accidents. Iranian J Emerg Med. 2016;3(1):23-7.
11. Hashemi E, Zangi M, Sadeghi-Bazargani H, Soares J, Viitasara E, Mohammadi R. Population-based epidemiology of non-fatal injuries in Tehran, Iran. Health Promot Perspect. 2018;8(2):127-32.
12. Byun CS, Park IH, Oh JH, Bae KS, Lee KH, Lee E. Epidemiology of Trauma Patients and Analysis of 268 Mortality Cases: Trends of a Single Center in Korea. Yonsei Med J. 2015;56(1):220-6.
13. Mitchell R, Curtis K, Watson WL, Nau T. Age differences in fall‐related injury hospitalisations and trauma presentations. Australas J Ageing. 2010;29(3):117-25.
14. Scheetz LJ. Relationship of age, injury severity, injury type, comorbid conditions, level of care, and survival among older motor vehicle trauma patients. Res Nurs Health. 2005;28(3):198-209.
15. Bonne S, Schuerer DJ. Trauma in the older adult: epidemiology and evolving geriatric trauma principles. Clin Geriatr Med. 2013;29(1):137-50.
16. Gross T, Morell S, Amsler F. longer-term quality of life following major trauma: age only significantly affects outcome after the age of 80 years. Clin Interv Aging. 2018;13:773-85.
17. Baratloo A, Shokravi M, Safari S, Aziz AK. Predictive Value of Glasgow Coma Score and Full Outline of Unresponsiveness Score on the Outcome of Multiple Trauma Patients. Arch Iran Med. 2016;19(3):215-20.
18. Baratloo A, Mirbaha S, Bahreini M, Banaie M, Safaie A. Outcome of Trauma Patients Admitted to Emergency Department Based on Full Outline of Unresponsiveness Score. Adv J Emerg Med. 2017;1(1):e2.
19. Jha N, Srinivasa D, Roy G, Jagdish S. Injury pattern among road traffic accident cases: A study from South India. Indian J Community Med. 2003;28(2):84-90.
20. Ramouz A, Hosseini M, Vahdati SS. Epidemiology of head and neck fractures caused by motorcycle accidents. Iranian J Emerg Med. 2016;3(1):23-7.
21. Thanni L, Kehinde O. Trauma at a Nigerian teaching hospital: pattern and documentation of presentation. Afr Health Sci. 2006;6(2):104-7.
22. Mahdian M, Sehat M, Fazel MR, Moraveji A, Mohammadzadeh M. Epidemiology of urban traffic accident victims hospitalized more than 24 hours in a level III trauma center, Kashan county, Iran, during 2012-2013. Arch Trauma Res. 2015;4(2):e28465.
23. Mehrpour SR, Nabian MH, Zanjani LO, Foroughmand-Araabi M-H, Kamrani RS. Descriptive epidemiology of traumatic injuries in 18890 adults: a 5-year-study in a tertiary trauma center in Iran. Asian J Sports Med. 2015;6(1): e23129.
24. Peymani P, Heydari S, Hoseinzadeh A, Sarikhani Y, Hedjazi A, Zarenezhad M, et al. Epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran: a community-based survey. Chin J Traumatol. 2012;15(5):279-83.
25. Morrison J, Yapp L, Beattie A, Devlin E, Samarage M, McCaffer C, et al. The epidemiology of Scottish trauma: A comparison of pre-hospital and in-hospital deaths, 2000 to 2011. Surgeon. 2016;14(1):1-6.
Files | ||
Issue | Vol 3 No 4 (2019): Autumn (October) | |
Section | Original article | |
Keywords | ||
Emergency Medical Services Epidemiologic Studies Wounds and Injuries |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |