European Journal of Molecular & Clinical Medicine

Abstract

Background: Trauma is a major public-health problem in India. With a population over one billion and an annual urbanization rate of 26%, the magnitude of the problem is a cause for concern. An unpresented increase in number of vehicles has outpaced the development of adequate roads and highways. Trauma especially RTA’S are the invariable fall out in the rapid motorization and urbanization in India. Aim: To study the physiological causes and temporal pattern of trauma death in the study population.
Materials and Methods: Study Design: Institutional based Retrospective and prospective study. Study area: The study was done in the Department of in medical college. Study Period: Retrospective period of 6 months and Prospective for 6 months. Study population: All trauma patients fatalities in the hospital and Patients brought dead to accident and emergency. Sample size: A total of 92 patients were included in the study. Prevalence of head injury = 60% (last year records) with an Absolute precision of 10% at 95% confidence interval. Required sample size = 92. Sampling method: Simple Random sampling method. Ethical consideration: Institutional Ethical committee permission was taken prior to the commencement of the study. Study tools and Data collection procedure: All severely injured patients will be evaluated from the time they arrive to the duration of stay in the hospital and eventual cause of death will be estimated. The reported time of death will be noted and its significant pattern of trauma deaths will be noted. A graphical illustration of modal distribution of death with a simple bar diagram showing the physiological cause of death and time duration from 0 - 6 hours, 6 – 12 hours, 12 – 24 hours, 24- 48 hours, 48 – 72 hours ,72 hours – 1 week, > 1 week will be done respectively. Statistical Analysis: The data was collected, compiled and compared statistically by frequency distribution and percentage proportion. Quantitative data variables were expressed by using Descriptive statistics (Mean ± SD). Qualitative data variables were expressed by using frequency and Percentage (%).
Results: Among these causes in our study Intractable intracranial hypertension was seen in 63% (n-58) cases, Hemorrhagic shock/ Bleeding 25% (n- 23), Sepsis/Multi organ failure 6% (n– 5), Intracranial Hypertension and Sepsis 3% (n- 3), Ventilation associated Problems 1% (n- 1), Intracranial Hypertension and Hemorrhagic shock 1% (n – 1), Hemorrhagic Shock and Sepsis 1% (n- 1).
Conclusion: Retrospective judgments on clinical decision-making, based on case record findings, must be examined with extreme caution, and this study has been careful to use only objective parameters, like prolonged operative time, or pre-operative physiological status. If the results remain valid in other Indian hospitals, it is worth noting that better identification and management of trauma patients could save a quarter of million lives each year, based on a 50% reduction of the estimated half a million annual hospital trauma deaths in India.