Epidemiology and patterns of trauma deaths in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan

Trauma is an ever increasing problem and it is the leading cause of morbidity and mortality in the under 40s age group in most developed and developing countries including Malaysia. The lack of research into trauma epidemiology is well known. The paucity of information has led to conclusion that...

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Main Author: Hussain, Hardawani Mohd
Format: Thesis
Language:English
Published: 2011
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Online Access:http://eprints.usm.my/57633/1/DR.%20HARDAWANI%20BINTI%20MOHD%20HUSSAIN%20-%20e.pdf
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spelling my-usm-ep.576332023-03-29T04:11:30Z Epidemiology and patterns of trauma deaths in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan 2011 Hussain, Hardawani Mohd RA643-645 Disease (Communicable and noninfectious) and public health Trauma is an ever increasing problem and it is the leading cause of morbidity and mortality in the under 40s age group in most developed and developing countries including Malaysia. The lack of research into trauma epidemiology is well known. The paucity of information has led to conclusion that proper epidemiological studies cannot be conducted in the absence of meaningful data. The objective of this study is to examine patterns of anatomical injury in victims of trauma death and to determine the probability of survival of trauma death patients. This was a retrospective evaluation of 75 consecutive of trauma files at Hospital Universiti Sains Malaysia, of all trauma death during I year period, beginning I st January 2008 until 31st December 2008. Patients who fulfill the inclusion criteria were selected for the study. Patients were analyzed for injury severity by standard scoring systems (Abbreviated Injury Scale [AIS], Revised Trauma Score [RTS], and Injury Severity Score [ISS], and Trauma and Injury Severity Scale [TRISS] methodology. 75 patients were enrolled. 84% (n=63) were male and 16% (n=l2) were female and all are Malays. Mean age group was 43.0 (SD=27.0). 45 (60%) patients were younger than 55 years old. Blunt injuries 73(97.33%) were the dominant mechanism in fatal trauma whereas penetrating injuries were only 2(2.67%). Majority of trauma death was due to MV A 82.67% (n=62). Total numbers with normotensive SBP (2: 90mmHg) versus hypotensive {<90 mmHg) on arrival were 73 and 2 patients, respectively. For normal respiration (RR 10-29/min) versus respiratory distress (RR>29 /min or <l O/min); the numbers found to be 72 and 3 patients respectively. Noted 18 patient with no or only minor and moderate head injury (GCS2:9) versus 57 patients with severe head injury (GCS<9). Cross-tabulated for age, victims {<55 years) were had a deranged cerebral status (GCS~8; X2-test, df= I, p<0.05) on arrival compare to older victims. The predominant cause of death was CNS injury in 77.3% (n=58), followed by SIRS/MOF in 18.7% (n=l4), exsanguinations 2.7 %( n=2) and others 1.3 %( n= I). Median of ISS was 25 (range: 9-54). The overall mean ISS score was 27 .6±8.6. There was statistically significant difference in the RTS for the three time to death groups (acute:< 48hrs; early: 3-7days; late >7 days) (F=9.820, p < 0.05). When using the Trunkey classification of immediate, early and late deaths, we found that a trend of deaths, clustering in a bimodal-like fashion when stratified according to cause of death. By using TRISS methodology, 62 (82.7%) patient had a Ps >0.5 and 41 of them were judged "frankly preventable" cPs>0.75). Despite a probability of survival above 80%, the early management has thrown up possibilities for prevention of trauma death, improving treatment strategies and enhancing trauma research. Focus on injury prevention is imperative, particularly for brain injuries. The figures from this study, mandate further exploration of preventability issues, management improvements, and areas of clinical awareness that should be apply not only to this trauma system, but also to similar systems as general. 2011 Thesis http://eprints.usm.my/57633/ http://eprints.usm.my/57633/1/DR.%20HARDAWANI%20BINTI%20MOHD%20HUSSAIN%20-%20e.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic RA643-645 Disease (Communicable and noninfectious) and public health
spellingShingle RA643-645 Disease (Communicable and noninfectious) and public health
Hussain, Hardawani Mohd
Epidemiology and patterns of trauma deaths in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan
description Trauma is an ever increasing problem and it is the leading cause of morbidity and mortality in the under 40s age group in most developed and developing countries including Malaysia. The lack of research into trauma epidemiology is well known. The paucity of information has led to conclusion that proper epidemiological studies cannot be conducted in the absence of meaningful data. The objective of this study is to examine patterns of anatomical injury in victims of trauma death and to determine the probability of survival of trauma death patients. This was a retrospective evaluation of 75 consecutive of trauma files at Hospital Universiti Sains Malaysia, of all trauma death during I year period, beginning I st January 2008 until 31st December 2008. Patients who fulfill the inclusion criteria were selected for the study. Patients were analyzed for injury severity by standard scoring systems (Abbreviated Injury Scale [AIS], Revised Trauma Score [RTS], and Injury Severity Score [ISS], and Trauma and Injury Severity Scale [TRISS] methodology. 75 patients were enrolled. 84% (n=63) were male and 16% (n=l2) were female and all are Malays. Mean age group was 43.0 (SD=27.0). 45 (60%) patients were younger than 55 years old. Blunt injuries 73(97.33%) were the dominant mechanism in fatal trauma whereas penetrating injuries were only 2(2.67%). Majority of trauma death was due to MV A 82.67% (n=62). Total numbers with normotensive SBP (2: 90mmHg) versus hypotensive {<90 mmHg) on arrival were 73 and 2 patients, respectively. For normal respiration (RR 10-29/min) versus respiratory distress (RR>29 /min or <l O/min); the numbers found to be 72 and 3 patients respectively. Noted 18 patient with no or only minor and moderate head injury (GCS2:9) versus 57 patients with severe head injury (GCS<9). Cross-tabulated for age, victims {<55 years) were had a deranged cerebral status (GCS~8; X2-test, df= I, p<0.05) on arrival compare to older victims. The predominant cause of death was CNS injury in 77.3% (n=58), followed by SIRS/MOF in 18.7% (n=l4), exsanguinations 2.7 %( n=2) and others 1.3 %( n= I). Median of ISS was 25 (range: 9-54). The overall mean ISS score was 27 .6±8.6. There was statistically significant difference in the RTS for the three time to death groups (acute:< 48hrs; early: 3-7days; late >7 days) (F=9.820, p < 0.05). When using the Trunkey classification of immediate, early and late deaths, we found that a trend of deaths, clustering in a bimodal-like fashion when stratified according to cause of death. By using TRISS methodology, 62 (82.7%) patient had a Ps >0.5 and 41 of them were judged "frankly preventable" cPs>0.75). Despite a probability of survival above 80%, the early management has thrown up possibilities for prevention of trauma death, improving treatment strategies and enhancing trauma research. Focus on injury prevention is imperative, particularly for brain injuries. The figures from this study, mandate further exploration of preventability issues, management improvements, and areas of clinical awareness that should be apply not only to this trauma system, but also to similar systems as general.
format Thesis
qualification_level Master's degree
author Hussain, Hardawani Mohd
author_facet Hussain, Hardawani Mohd
author_sort Hussain, Hardawani Mohd
title Epidemiology and patterns of trauma deaths in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan
title_short Epidemiology and patterns of trauma deaths in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan
title_full Epidemiology and patterns of trauma deaths in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan
title_fullStr Epidemiology and patterns of trauma deaths in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan
title_full_unstemmed Epidemiology and patterns of trauma deaths in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan
title_sort epidemiology and patterns of trauma deaths in hospital universiti sains malaysia, kubang kerian, kelantan
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Perubatan
publishDate 2011
url http://eprints.usm.my/57633/1/DR.%20HARDAWANI%20BINTI%20MOHD%20HUSSAIN%20-%20e.pdf
_version_ 1776101204325040128