Trauma Patients at Risk of In-Hospital Mortality

Abstract

The trauma incidence in South Africa is significantly high and forms one of the top-five causes of unnatural death. Thus, one of the higher incidences of trauma across the world. Subsequently the in-hospital mortality forms a high burden of disease on the health systems in South African health care facilities. Therefore, analysing the incidence of trauma and the various mechanisms of trauma allows for in-hospital trauma mortalities to assessed. The aim of this study was to analyse the in-hospital mortality distribution factors at a Johannesburg Trauma unit over an eight-year retrospective review from 01 January 2005 –31 December 2012 and Analysis of Trauma Bank data forms at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Looking at demographics, physiological parameters, mechanism of Injury, Injury Severity Score (ISS) and New Injury Severity Score (NISS). Ethics through the Wits Ethics Committee was obtained. The Statistica V8 application was used to analyse the data that was collected and a P value of <0.05 was reported as significant. A total of 18, 087 Priority 1 patients were reviewed in this study. This sample demonstrated the 21-45 years of age group was the most affected trauma group (87.3%). Penetrating injuries (Stab and gunshot wounds) had the highest incidence yet lower mortalities. However, blunt injuries (ranging from Pedestrian- and Motor- vehicle crashes, blunt assaults, falls and burns) had lower incidences and higher mortalities. The highest in-hospital mortality was due to burns patients (22.56%) followed by pedestrian vehicle crashes patients affecting the predominantly young male population. Poor probability of survival was demonstrated amongst Motor Vehicle Crashes (Ps 44%) and Motorbike Crashes (34%), and PVCs.