Open AccessAn Analysis of 30‐Day in‐Hospital Trauma Mortality in Four Urban University Hospitals Using the Australia India Trauma Registry
Author(s) -
Bhandarkar Prashant,
Patil Priti,
Soni Kapil Dev,
O'Reilly Gerard M.,
Dharap Satish,
Mathew Joseph,
Sharma Naveen,
Sarang Bhakti,
Gadgil Anita,
Roy Nobhojit
Publication year - 2021
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-020-05805-7
Subject(s) - medicine , emergency medicine , major trauma , population , mortality rate , vital signs , injury severity score , trauma care , injury prevention , poison control , pediatrics , medical emergency , surgery , environmental health
Background India has one‐sixth (16%) of the world's population but more than one‐fifth (21%) of the world's injury mortality. A trauma registry established by the Australia India Trauma Systems Collaboration (AITSC) Project was utilized to study 30‐day in‐hospital trauma mortality at high‐volume Indian hospitals. Methods The AITSC Project collected data prospectively between April 2016 and March 2018 at four Indian university hospitals in New Delhi, Mumbai, and Ahmedabad. Patients admitted with an injury mechanism of road or rail‐related injury, fall, assault, or burns were included. The associations between demographic, physiological on‐admission vitals, and process‐of‐care parameters with early (0–24 h), delayed (1–7 days), and late (8–30 days) in‐hospital trauma mortality were analyzed. Results Of 9354 patients in the AITSC registry, 8606 were subjected to analysis. The 30‐day mortality was 12.4% among all trauma victims. Early (24‐h) mortality was 1.9%, delayed (1–7 days) mortality was 7.3%, and late (8–30 days) mortality was 3.2%. Abnormal physiological parameters such as a low SBP, SpO2, and GCS and high HR and RR were observed among non‐survivors. Early initiation of trauma assessment and monitoring on arrival was an important process of care indicator for predicting 30‐day survival. Conclusions One in ten admitted trauma patients (12.4%) died in urban trauma centers in India. More than half of the trauma deaths were delayed, beyond 24 h but within one week following injury. On‐admission physiological vital signs remain a valid predictor of early 24‐h trauma mortality.