30‐Day In‐hospital Trauma Mortality in Four Urban University Hospitals Using an Indian Trauma Registry

Roy, Nobhojit; Martin, Guillaume; Ghosh, Subhasis; Gupta, Amit; Kumar, Vineet; Khajanchi, Monty; Schneider, Eric B.; Gruen, Russell L.; Tomson, Göran; Schreeb, Johan von

doi:10.1007/s00268-016-3452-y

Cited by 55 publications

(44 citation statements)

References 34 publications

(33 reference statements)

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“…The 30‐day mortality rate for the entire TITCO cohort (surgery or no surgery) is 21·4 per cent, slightly lower than the 30‐day perioperative mortality rate of 23·1 per cent reported here. This perioperative mortality rate is high compared with rates for emergency surgery from several studies in other low‐resource settings (hospitals in the Democratic Republic of Congo, Central African Republic, South Sudan, Papua New Guinea and South Africa).…”

Section: Discussioncontrasting

confidence: 73%

“…India has no formal prehospital transport or trauma system, and most directly admitted injured patients arrive at health centres by informal means of transport (taxi, police, private car). During the data collection phase of this study, the participating centres did not formally adhere to any of the WHO Emergency and Essential Surgical Care Programme guidelines, and the All‐India Institute of Medical Sciences was the only centre to formally implement the Advanced Trauma Life Support (ATLS®) programme.…”

Section: Methodsmentioning

confidence: 99%

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Mortality following surgery for trauma in an Indian trauma cohort

Mansourati

Kumar

Khajanchi

et al. 2018

British Journal of Surgery

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Section: Discussioncontrasting

confidence: 73%

Section: Methodsmentioning

confidence: 99%

Mortality following surgery for trauma in an Indian trauma cohort

Mansourati

Kumar

Khajanchi

et al. 2018

British Journal of Surgery

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“…TITCO data collection was carried out from October 1, 2013, to July 24, 2014. [8] Patients with a valid recording of HR and BP on admission are considered for this study. Only patients with age more than 18 years were included in this study.…”

Section: Methodsmentioning

confidence: 99%

On-admission blood pressure and pulse rate in trauma patients and their correlation with mortality: Cushing's phenomenon revisited

Bhandarkar

Munivenkatappa

Roy

et al. 2017

Int J Crit Illn Inj Sci

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Background:Injury-induced alteration in initial physiological responses such as hypertension and heart rate (HR) has a significant effect on mortality. Research on such associations from our country-India is limited. The present study investigates the injury-induced early blood pressure (BP) and HR changes and their association with mortality.Materials and Methods:The data were selected from Towards Improved Trauma Care Outcomes collected from October 1, 2013, to July 24, 2014. Patients above 18 years of age with documented systolic BP (SBP) and HR were selected. BP was categorized into hypotension (SBP <90 mmHg), hypertension (SBP >140 mmHg), and normal (SBP 90–140 mmHg). HR was categorized into bradycardia (HR <60 beats/min [bpm]), tachycardia (HR >100 bpm), and normal (HR 60–100 bpm). These categories were compared with mortality.Results:A total of 10,200 patients were considered for the study. Mortality rate was 24%. Mortality among females was more than males. Patients with normal BP and HR had 20% of mortality. Mortality in patients with abnormal BP and HR findings was 36%. Mortality was higher among hypotension-bradycardia patients (80%) followed by hypertension-bradycardia patients (58%) and tachycardia hypotension patients (48%). Elderly patients were at higher risk of deaths with an overall mortality of 35% compared to 23% of adults.Conclusion:The study reports that initial combination of hypotension-bradycardia had higher mortality rate. Specific precautions in prehospital care should be given to trauma patients with these findings. Further prospective study in detail should be considered for exploring this abnormality.

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“…Estimates of total fatalities during the offensive vary. A report by the UN Assistance Mission for Iraq and the Office of the UN High Commissioner for Human Rights estimates that 2521 civilians were killed, while aggregate data compiled by the Associated Press estimate that there were between 9000 and 11,000 civilian fatalities [1, 2]. …”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Trauma Patients from the Mosul Offensive, 2016–2017: Results from a Dedicated Trauma Center in Erbil, Iraqi Kurdistan

et al. 2018

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IntroductionMost epidemiological studies from conflicts are restricted to either combatants or civilians. It is largely unknown how the epidemiology differs between the two groups. In 2016, an Iraqi-led coalition began retaking Mosul from the terrorist group Islamic State of Iraq and Syria. One key institution that received trauma patients from Mosul was Emergency Management Center (EMC) in Erbil, 90 km away. The aim of this study was to describe the epidemiology, morbidity, and mortality of civilians and combatants admitted during the ongoing conflict.MethodThis retrospective cohort study utilized routinely collected data on patients with conflict-related injuries who were admitted to EMC between October 16, 2016, and July 10, 2017. Data processing and analysis was carried out using JMP 13. Categorical variables were compared using Fisher’s exact test.ResultsThe analysis included 1725 patients, out of which 46% were civilian. Ordnance accounted for most injuries (68%), followed by firearms (18%) and improvised explosive devices (IEDs) (14%). The proportion of IED-related injuries among combatants were almost three times that of civilians. The proportions of abdominal injuries, need for surgery, laparotomies, and amputations were significantly higher among civilians than among combatants. The mortality rate was 0.5%.DiscussionThe fact that civilians had greater surgical needs than combatants may be explained by several factors including a lack of ballistic protection. The extremely low mortality rate indicates significant gaps in prehospital care and transport. Our results may provide useful information to guide medical preparedness and response during future conflicts.Clinicaltrials.gov IDNCT03358758.

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30‐Day In‐hospital Trauma Mortality in Four Urban University Hospitals Using an Indian Trauma Registry

Cited by 55 publications

References 34 publications

Mortality following surgery for trauma in an Indian trauma cohort

Mortality following surgery for trauma in an Indian trauma cohort

On-admission blood pressure and pulse rate in trauma patients and their correlation with mortality: Cushing's phenomenon revisited

Epidemiology of Trauma Patients from the Mosul Offensive, 2016–2017: Results from a Dedicated Trauma Center in Erbil, Iraqi Kurdistan

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