An audit of trauma related mortality in Government Medical College, Jammu
DOI:
https://doi.org/10.18203/2320-6012.ijrms20222842Keywords:
Audit, Critical, Mortality, Systematic, Trauma, VulnerableAbstract
Background: Surgical audit is defined as a systematic, critical analysis of the quality of surgical care that is reviewed by peers against explicit criteria or recognized standards, and then used to further inform and improve surgical practice with the ultimate goal of improving the quality of care for patients. Aims and objectives were to study the profile of patients who died due to trauma and to identify factors involved in both pre-hospital and hospital care.
Methods: This study was conducted in the department of surgery, GMC Jammu during over a period of one year. The profile of all traumatic deaths was studied to evaluate the various causes of trauma related mortality, age and sex relationship, mortality rate, prognostic indicators and also to identify factors involved in both pre-hospital and hospital care.
Results: A total of 414 deaths occurred due to trauma. Out of these 317 patients were males and 97 patients were females comprising male to female ratio of 3.3:1. Road traffic accidents accounted for majority of the deaths (57%) followed by falls (35.5%), assaults (5.07%) and miscellaneous causes (2.43%). In children less than 15 years of age, traumatic deaths were more due to falls, whereas in adults it was more due to road traffic accidents. In our study there was steady rise of fatalities during weekend days with a peak on Saturday. Cranio-cerebral injuries were responsible for majority of the traumatic deaths (85.9%) followed by limb injuries including fractures (38.4%), thoracic injuries (27.7%), abdominal injuries (24.6%), pelvic injuries (20.7%) and spine injuries (14.2%).
Conclusions: This study can be the impetus to motivate committed professionals in the trauma specialty to help in the organization of available facilities and to upgrade existing facilities for a better response to injury, which should not be different from other public health responses.
References
Gordon MW, Luke C, Robertson CE, Busuttil A. An audit of trauma deaths occurring in the accident and emergency department. Emerg Med J. 1989;6(2):107-15.
Moodley NB, Aldous C, Clarke DL. An Audit of trauma related mortality in a provincial capital in South Africa. S Afr J Surg. 2014;52(4):101-4.
Cales RH, Trunkey DD. Preventable trauma deaths: a review of trauma care systems development. J Am Med Assoc. 1993;254:1059-63.
Jennett B, Teasdale G, Galbraith S, Pickard J, Grant H, Braakman R, et al. Severe head injuries in three countries. J Neurol Neurosurg Psychiatr. 1977;40(3):291-8.
Mishra HB, Shadangi TN. Predictability of prognosis in head injury using Glasgow Coma Scale as an index. J Neurol India. 1990;38:177-82.
Ropper AH. Trauma of the head and spinal cord. In: Braunwald E, Petersdorf RG, Wilson JD, Martin JB, Root RT, Fauci AS, eds. Harrisons’ Principles of Internal Medicine. International edition. McGraw Hill Inc.; 1991:1991-2002.
Bindroo S, Saraf R. Lessons learned in a developing nation. Int J Surg Surg Mortal Audit. 2015;100(6):1026-32.
Barr JB, Ralston GJ. Head Injuries in a peripheral hospital, a five-year survey. Lancet. 1964;2(1):519-22
Rowbotham GF, Maciver IN, Dickson J, Bousfield ME. Analysis of 1,400 cases of acute injury to the head. Br Med J. 1954;1(4864):726.
Nestvold K, Lundar T, Lonnum A. Head injuries during one year in a Central Hospital in Norway- a prospective study. J Neuroepidemiol. 1988;7:134-44.
Kalyanaraman S, Ramamoorthy K, Ramamurthi B. an analysis of 2000 cases of head injury. J Neurol India. 1970;18(4):3-11.
Anderson ID, Woodford M, De Dombal FT, Irving M. Retrospective study of 1000 deaths from injury in England and Wales. Br Med J. 1988;296(6632):1305-8.
Swann IJ, Millian R, Strong I. Head injuries at an inner city- accident and emergency department. Br J Accid Surg. 1981;12(4):174-8.
Sambasivan M. Survey of the problems of head injuries in India. J Neurol. 1977;25(2):51-9.
Devadiga KV, Jain SP. An analytical study of acute head injury. Indian J Surg. 1969;52(1):22-6.
Lewin W, Kennedy WFC. Motor cyclists, crash helmets and head injuries. Br Med J.1956;1:125-6.
Smith J, Caldwell E, D’Amours S, Jalaludin B, Sugrue M. Abdominal trauma: a disease in evolution. ANZ J Surg. 2005;75(9):790-4.
Galbraith S, Murray WR, Patel AR, Knill-Jones R. The relationship between alcohol and head injury and its effect on the conscious level. J Br Surg. 1976;63(2):128-30.
