Background: There are many published studies about loss of consciousness related to general trauma however works on loss of consciousness in respect to orthopedic injuries are scarce.Aim: The aim of this study was to investigate whether loss of consciousness worsens the prognosis of patients with orthopedic injuries.Method: A retrospective cohort study of orthopedic traumas was performed in the university Hospital of Base in São José do Rio Preto. All accident victims with injuries of the extremities classified as Score 3 or 4 by the Abbreviated Injury Scale (AIS) were included in this observational quantitative study. Patients with minor injuries and injuries that did not involve the extremities were not included. The association of loss of consciousness at the scene of the accident with evolution to death was investigated. The t-test, chi-squared and Fisher exact tests, and relative risk were used for statistical analysis. An alpha error of 5% (p-value ≤ 0.05) was considered statistically significant.Results: A total of 245 patients with ages between 13 and 98 years old and a mean of 45.4 years had extremity AIS scores of 3 or 4. Of these, significantly more men (170 - p< 0.001) suffered this type of injury than women (71). Thirty-six (14.94%) of these patients lost consciousness compared to 205 (85.06%) who did not lose consciousness. The total death rate in this group of patients was 5.39%; 9 (25%) of the 36 patients who lost consciousness and 4 (1.95%) of the 205 who did not lose consciousness died (Fisher exact test: p-value = 0.0001 and relative risk = 12,813 – 95% confidence index: 4,166 to 39,408).Conclusion: Loss of consciousness in patients with orthopedic injuries of the extremities is associated to a higher death rate.
Background:The aim of this study was to evaluate one-month hospital mortality in victims with injuries of the extremities.Methods:All accident victims admitted to the Hospital de Base in São José do Rio Preto, Brazil, during the period from July 2004 to June 2005, were evaluated in an observational study. Patients were classified using the Abbreviated Injury Scale (AIS). Patients with severe injuries of the extremities (AIS 3–4) were compared with those without injuries or with minor extremity injuries (AIS 0–2).Results:A total of 3489 accident victims were evaluated; 3244 (92.98%) did not suffer injuries or had minor injuries of the extremities (AIS 0–2) and 245 (7.02%) had severe injuries (AIS 3–4). Of the 245 patients with AIS 3–4 extremity injuries, 13 (5.31%) patients died, and of those without severe injuries to the extremities, 34 (1.05%) died (Fisher’s Exact test P = 0.0000, relative risk 5.063, 95% confidence interval [CI]: 2.707–9.467).Conclusion:Patients with injuries of the extremities are at greater risk of death than accident victims with other types of trauma.
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