Epidemiology of Fatal Injuries among Patients Admitted at Sina Hospital, the National Trauma Registry of Iran, 2016-2019
-
Melika Khaleghi-Nekou
,
Ali Moradi
,
Mohammadreza Zafarghandi
,
Ahmad Fayaz-Bakhsh
,
Mina Saeednejad
,
Vafa Rahimi-Movaghar
,
Mahdi Sharif-Alhoseini
,
Esmaeil Fakharian
,
Moein Khormali
,
Mahdi Mohammadzadeh
,
Homayoun Sadeghi-Bazargani
,
Hamid Pahlavanhosseini
,
Habibollah Pirnejad
,
Aria Rahmani
,
Saeid Soltani
,
Khatereh Naghdi
,
Somayeh Bahrami
,
Melika Ozlaty
,
Payman Salamati
Abstract
Introduction: Injuries cause high rates of mortality and harm to millions of people annually. Objective: The aims of this study were to assess some characteristics of hospitalized trauma patients and determine the variables which were associated with increased rates of mortality. Methods: Data were extracted from the National Trauma Registry of Iran (NTRI) data bank. Among all trauma patients admitted to Sina Hospital, those who had one of the following were registered in the NTRI: hospitalization for more than 24 hours, death less than 24 hours in the hospital, and transferring from the intensive care unit (ICU) of another hospital. Recorded data relating to the interval between 24 July 2016 and 10 October 2019 were analyzed. Results: A total number of 3430 patients were studied, of whom 78 (0.02%) did not survive. The mean age of survivors was 38.4 (±18.5) and it was 58.1 (±23.7) for non-survivors (p<0.001). The mean Glasgow coma scale (GCS) of survivors was 14.9 (±0.7) and it was 11.7 (±4.4) for non-survivors (p<0.001). The most important predictors of death were ICU admission (OR 4.31; 95% CI 1.65-11.26) and not having surgical operation (OR 6.08; 95% CI 2.30-16.03). The injuries with higher injury severity score (ISS) had higher risks of death (OR 1.20; 95% CI 1.06-1.36). Conclusions: In this study, Road Traffic Crashes (RTCs) were the main cause of injuries. The elder age, lower GCS score, ICU admission, higher ISS and not having surgical operation were the worst factors of death. More studies are needed to reveal other prognostic factors of fatal injuries.
1. World Health Organization. WHO Health topics, Injuries, [n.d.]. Available from: http://www.emro.who.int/health-topics/injuries/index.html, .
2. World Health Organization. The top 10 causes of death, 2018, [cited 2018, 24 May,]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death,.
3. World Health Organization. Global status report on road safety 2018, 2018, [cited 2018, n.d.]. Available from: https://www.who.int/violence_injury_prevention/road_safety_status/2018/en/,.
4. Peden M, McGee K, Sharma G. The injury chart book: a graphical overview of the global burden of injuries. Geneva: World Health Organization. 2002 Apr 3;5.
5. Haji Aghajani M, Haddadi M, Saadat S. Epidemiological Pattern of Injuries in Iran; a Nationwide Review of Seven Million Emergency Department Admissions. Emergency. 2017;5(1):e10.
6. Azami-Aghdash S, Abolghasem Gorji H, Sadeghi-Bazargani H, Shabaninejad H. Road Traffic Injuries Epidemiology in Iran: Based on the Data from Disaster Management Information System (DMIS) Of the Iranian Red Crescent. Iran Red Crescent Med J. 2017;19(1):e38743.
7. Saadat S, Yousefifard M, Asady H, Moghadas Jafari A, Fayaz M, Hosseini M. The Most Important Causes of Death in Iranian Population; a Retrospective Cohort Study. Emergency. 2015;3(1):16-21.
8. Institute for Health Metrics and Evaluation(IHME). What causes the most death and disability combined? 2017. [Available from: http://www.healthdata.org/iran].
9. Ehteram H, Sharif-Alhoseini M. Designing trauma registry system using a logical framework approach. Chinese J Traumatol. 2013;16(5):316-8.
10. Ghodsi Z, Rahimi-Movaghar V, 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. Arch Trauma Res. 2017;6(2):1-7.
11. 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):286-92.
12. The Abbrevated Injury Scale, 2015 Revision, Chicago, ll USA: Association for Advancement of Automotive Medicine. page: 228.
13. Gomez D, Sarrami P, Singh H, Balogh ZJ, Dinh M, Hsu J. External benchmarking of trauma services in New South Wales: Risk-adjusted mortality after moderate to severe injury from 2012 to 2016. Injury. 2019;50(1):178-85.
14. Curtis K, Caldwell E, Delprado A, Munroe B. Traumatic injury in Australia and New Zealand. Australas Emerg Nurs J. 2012;15(1):45-54.
15. Zhang M, Guo M, Guo X, Gao L, Zhou J, Bai X, et al. Unintentional injuries: A profile of hospitalization and risk factors for in-hospital mortality in Beijing, China. Injury. 2019;50(3):663-70.
16. Kunitake RC, Kornblith LZ, Cohen MJ, Callcut RA. Trauma early mortality prediction tool (TEMPT) for assessing 28-day mortality. Trauma Surg Acute Care Open. 2018;3(1):e000131.
17. Yadollahi M. A study of mortality risk factors among trauma referrals to trauma center, Shiraz, Iran, 2017. Chinese J Traumatol. 2019;22(4):212-8.
18. Yadollahi M, Ghiassee A, Anvar M, Ghaem H, Farahmand M. Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011-2014 data. Chinese J Traumatol. 2017;20(1):27-33.
19. Abbasi H, Bolandparvaz S, Yadollahi M, Anvar M, Farahgol Z. Time distribution of injury-related in-hospital mortality in a trauma referral center in South of Iran (2010-2015). Medicine (Baltimore). 2017;96(21):e6871.
20. Bege T, Pauly V, Orleans V, Boyer L, Leone M. Epidemiology of trauma in France: mortality and risk factors based on a national medico-administrative database. Anaesth Crit Care Pain Med. 2019;38(5):461-8.
21. Na'emani F, Fayaz-Bakhsh A, Sohrabi Z, Zali ME. Service required for elderly receiving home care: a situational analysis.Payes. 2019;18(6):513-25.
22. Na'emani F, Esmaiil Zali M, Sohrabi Z, Fayaz-Bakhsh A. Prevalence of Risk Factors for Falls Among the Elderly Receiving Care at Home. Salmand. 2019;13(5):638-51.
23. Wu SC, Rau CS, Kuo SCH, Chien PC, Hsieh HY, Hsieh CH. The Reverse Shock Index Multiplied by Glasgow Coma Scale Score (rSIG) and Prediction of Mortality Outcome in Adult Trauma Patients: A Cross-Sectional Analysis Based on Registered Trauma Data. Int J Environ Res Public Health. 2018;15(11):2346.
24. Sarani B, Temple-Lykens B, Kim P, Sonnad S, Bergey M, Pascual JL, et al. Factors associated with mortality and brain injury after falls from the standing position. J Trauma. 2009;67(5):954-8.
25. Yadollahi M, Mahmoudi A, Niakan M, Fadaei Dashti M. Evaluating Risk Factors of Geriatric Trauma Mortality by Logistic Regression; A Cross-Sectional Study in 2011 - 2016. Iran Red Crescent Med J. 2018;20(5):e56049.
26. Abbasi HR, Mousavi SM, Taheri Akerdi A, Niakan MH, Bolandparvaz S, Paydar S. Pattern of Traumatic Injuries and Injury Severity Score in a Major Trauma Center in Shiraz, Southern Iran. Bull Emerg Trauma. 2013;1(2):81-5.
27. Oakley PA, Coleman NA, Morrison PJ. Intensive care of the trauma patient. Resuscitation. 2001;48(1):37-46.
28. Stewart KA, Groen RS, Kamara TB, Farahzad MM, Samai M, Cassidy LD, et al. Traumatic injuries in developing countries: report from a nationwide cross-sectional survey of Sierra Leone. JAMA Surg. 2013;148(5):463-9.
29. Khushboo Sheth. The Leading Causes Of Death In India, 2017 [cited 2017, April 25.]. Available from: https://www.worldatlas.com/articles/the-leading-causes-of-death-in-india.html,.
30. Xu J, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2015. NCHS Data Brief. 2016(267):1-8.
31. Valderrama-Molina CO, Giraldo N, Constain A, Puerta A, Restrepo C, Leon A, et al. Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population. Eur J Orthop Surg Traumatol. 2017;27(2):213-20.
32. Zargar M, Modaghegh MH, Rezaishiraz H. Urban injuries in Tehran: demography of trauma patients and evaluation of trauma care. Injury. 2001;32(8):613-7.
33. Azami-Aghdash S, Sadeghi-Bazargani H, Shabaninejad H, Abolghasem Gorji H. Injury epidemiology in Iran: a systematic review. J Inj Violence Res. 2017;9(1):27-40.
34. Sarmiento Altamirano D, Himmler A, Chango Sigüenza O, Pino Andrade R, Flores Lazo N, Reinoso Naranjo J, et al. The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador. World J Surg. 2020;44(6):1736-44.
35. Hu PY, Chen XY, Chen XH, Chen YM. Trauma care construction under the guidance of county-level trauma centers. Chinese J Traumatol. 2018;21(5):256-60.
36. Kuo BJ, Vaca SD, Vissoci JRN, Staton CA, Xu L, Muhumuza M, et al. A prospective neurosurgical registry evaluating the clinical care of traumatic brain injury patients presenting to Mulago National Referral Hospital in Uganda. PLoS One. 2017;12(10):e0182285.
2. World Health Organization. The top 10 causes of death, 2018, [cited 2018, 24 May,]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death,.
3. World Health Organization. Global status report on road safety 2018, 2018, [cited 2018, n.d.]. Available from: https://www.who.int/violence_injury_prevention/road_safety_status/2018/en/,.
4. Peden M, McGee K, Sharma G. The injury chart book: a graphical overview of the global burden of injuries. Geneva: World Health Organization. 2002 Apr 3;5.
5. Haji Aghajani M, Haddadi M, Saadat S. Epidemiological Pattern of Injuries in Iran; a Nationwide Review of Seven Million Emergency Department Admissions. Emergency. 2017;5(1):e10.
6. Azami-Aghdash S, Abolghasem Gorji H, Sadeghi-Bazargani H, Shabaninejad H. Road Traffic Injuries Epidemiology in Iran: Based on the Data from Disaster Management Information System (DMIS) Of the Iranian Red Crescent. Iran Red Crescent Med J. 2017;19(1):e38743.
7. Saadat S, Yousefifard M, Asady H, Moghadas Jafari A, Fayaz M, Hosseini M. The Most Important Causes of Death in Iranian Population; a Retrospective Cohort Study. Emergency. 2015;3(1):16-21.
8. Institute for Health Metrics and Evaluation(IHME). What causes the most death and disability combined? 2017. [Available from: http://www.healthdata.org/iran].
9. Ehteram H, Sharif-Alhoseini M. Designing trauma registry system using a logical framework approach. Chinese J Traumatol. 2013;16(5):316-8.
10. Ghodsi Z, Rahimi-Movaghar V, 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. Arch Trauma Res. 2017;6(2):1-7.
11. 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):286-92.
12. The Abbrevated Injury Scale, 2015 Revision, Chicago, ll USA: Association for Advancement of Automotive Medicine. page: 228.
13. Gomez D, Sarrami P, Singh H, Balogh ZJ, Dinh M, Hsu J. External benchmarking of trauma services in New South Wales: Risk-adjusted mortality after moderate to severe injury from 2012 to 2016. Injury. 2019;50(1):178-85.
14. Curtis K, Caldwell E, Delprado A, Munroe B. Traumatic injury in Australia and New Zealand. Australas Emerg Nurs J. 2012;15(1):45-54.
15. Zhang M, Guo M, Guo X, Gao L, Zhou J, Bai X, et al. Unintentional injuries: A profile of hospitalization and risk factors for in-hospital mortality in Beijing, China. Injury. 2019;50(3):663-70.
16. Kunitake RC, Kornblith LZ, Cohen MJ, Callcut RA. Trauma early mortality prediction tool (TEMPT) for assessing 28-day mortality. Trauma Surg Acute Care Open. 2018;3(1):e000131.
17. Yadollahi M. A study of mortality risk factors among trauma referrals to trauma center, Shiraz, Iran, 2017. Chinese J Traumatol. 2019;22(4):212-8.
18. Yadollahi M, Ghiassee A, Anvar M, Ghaem H, Farahmand M. Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011-2014 data. Chinese J Traumatol. 2017;20(1):27-33.
19. Abbasi H, Bolandparvaz S, Yadollahi M, Anvar M, Farahgol Z. Time distribution of injury-related in-hospital mortality in a trauma referral center in South of Iran (2010-2015). Medicine (Baltimore). 2017;96(21):e6871.
20. Bege T, Pauly V, Orleans V, Boyer L, Leone M. Epidemiology of trauma in France: mortality and risk factors based on a national medico-administrative database. Anaesth Crit Care Pain Med. 2019;38(5):461-8.
21. Na'emani F, Fayaz-Bakhsh A, Sohrabi Z, Zali ME. Service required for elderly receiving home care: a situational analysis.Payes. 2019;18(6):513-25.
22. Na'emani F, Esmaiil Zali M, Sohrabi Z, Fayaz-Bakhsh A. Prevalence of Risk Factors for Falls Among the Elderly Receiving Care at Home. Salmand. 2019;13(5):638-51.
23. Wu SC, Rau CS, Kuo SCH, Chien PC, Hsieh HY, Hsieh CH. The Reverse Shock Index Multiplied by Glasgow Coma Scale Score (rSIG) and Prediction of Mortality Outcome in Adult Trauma Patients: A Cross-Sectional Analysis Based on Registered Trauma Data. Int J Environ Res Public Health. 2018;15(11):2346.
24. Sarani B, Temple-Lykens B, Kim P, Sonnad S, Bergey M, Pascual JL, et al. Factors associated with mortality and brain injury after falls from the standing position. J Trauma. 2009;67(5):954-8.
25. Yadollahi M, Mahmoudi A, Niakan M, Fadaei Dashti M. Evaluating Risk Factors of Geriatric Trauma Mortality by Logistic Regression; A Cross-Sectional Study in 2011 - 2016. Iran Red Crescent Med J. 2018;20(5):e56049.
26. Abbasi HR, Mousavi SM, Taheri Akerdi A, Niakan MH, Bolandparvaz S, Paydar S. Pattern of Traumatic Injuries and Injury Severity Score in a Major Trauma Center in Shiraz, Southern Iran. Bull Emerg Trauma. 2013;1(2):81-5.
27. Oakley PA, Coleman NA, Morrison PJ. Intensive care of the trauma patient. Resuscitation. 2001;48(1):37-46.
28. Stewart KA, Groen RS, Kamara TB, Farahzad MM, Samai M, Cassidy LD, et al. Traumatic injuries in developing countries: report from a nationwide cross-sectional survey of Sierra Leone. JAMA Surg. 2013;148(5):463-9.
29. Khushboo Sheth. The Leading Causes Of Death In India, 2017 [cited 2017, April 25.]. Available from: https://www.worldatlas.com/articles/the-leading-causes-of-death-in-india.html,.
30. Xu J, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2015. NCHS Data Brief. 2016(267):1-8.
31. Valderrama-Molina CO, Giraldo N, Constain A, Puerta A, Restrepo C, Leon A, et al. Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population. Eur J Orthop Surg Traumatol. 2017;27(2):213-20.
32. Zargar M, Modaghegh MH, Rezaishiraz H. Urban injuries in Tehran: demography of trauma patients and evaluation of trauma care. Injury. 2001;32(8):613-7.
33. Azami-Aghdash S, Sadeghi-Bazargani H, Shabaninejad H, Abolghasem Gorji H. Injury epidemiology in Iran: a systematic review. J Inj Violence Res. 2017;9(1):27-40.
34. Sarmiento Altamirano D, Himmler A, Chango Sigüenza O, Pino Andrade R, Flores Lazo N, Reinoso Naranjo J, et al. The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador. World J Surg. 2020;44(6):1736-44.
35. Hu PY, Chen XY, Chen XH, Chen YM. Trauma care construction under the guidance of county-level trauma centers. Chinese J Traumatol. 2018;21(5):256-60.
36. Kuo BJ, Vaca SD, Vissoci JRN, Staton CA, Xu L, Muhumuza M, et al. A prospective neurosurgical registry evaluating the clinical care of traumatic brain injury patients presenting to Mulago National Referral Hospital in Uganda. PLoS One. 2017;12(10):e0182285.
| Files | ||
| Issue | Vol 5 No 1 (2021): Winter (February) | |
| Section | Original article | |
| Keywords | ||
| Fatal Outcome Registries Trauma Severity Indices Wounds and Injuries | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Khaleghi-Nekou M, Moradi A, Zafarghandi M, Fayaz-Bakhsh A, Saeednejad M, Rahimi-Movaghar V, Sharif-Alhoseini M, Fakharian E, Khormali M, Mohammadzadeh M, Sadeghi-Bazargani H, Pahlavanhosseini H, Pirnejad H, Rahmani A, Soltani S, Naghdi K, Bahrami S, Ozlaty M, Salamati P. Epidemiology of Fatal Injuries among Patients Admitted at Sina Hospital, the National Trauma Registry of Iran, 2016-2019. Front Emerg Med. 2020;5(1):e9.
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