Causality of injury and outcome in patients admitted in a major trauma center in North India

CONTEXT: Trauma in South Asia is an increasingly significant problem, particularly in light of increasing motorization. Societal changes are resulting in alterations in the epidemiology of trauma. AIMS: To assess various epidemiological parameters that influence causation of injury in the patients admitted in a major trauma center in Northern India. SETTINGS AND DESIGN: Prospective, cross-sectional, Hospital based study from August 2008 to July 2009. MATERIALS AND METHODS: A prospective study of 748 patients chosen by random assortment was carried out over a period of 1 year (August 2008 to July 2009) and following parameters were noted: Age group, sex, mode of trauma, type of injury, place where the trauma occurred and factors leading to injury. The length of stay of patients, Kampala trauma score (KTS) and mortality depending on the arrival time in emergency department was also noted. STATISTICAL ANALYSIS: Data analysis was performed using SPSS Version 16. RESULTS: Overall trauma was most common in the age group 15-30 years (Mean age: 29.43 ± 16.87 years), with male constituting 85.29% of the total patients. It was observed that road side injuries were the most frequent (66.71%) site of injuries, whereas household injuries (23.66%), farm site (6.28%), work place (1.60) were the next most common modes of trauma. Mean time of presentation of injured patient was 2.53 ± 4.92 days. About 48.13% patients were admitted after more than 24 h after the injury. Two wheelers (32.09) were found to be the most common mode of injury. Maximum injuries (65.31%) occurred in the rural setting. The overall length of hospital stay ranged from 2 days to 178 days (median15.6 days). Mortality is more in patients who arrive in night (between 9 pm and 5 pm). CONCLUSIONS: We conclude that the majority of injuries are preventable and the epidemiological trends differ from that of developed countries. Therefore, preventive strategies should be made on the basis of these epidemiological trends.