Open Access Emergency Medicine (Jul 2018)
Patterns of injuries and predictors of inhospital mortality in trauma patients in Saudi Arabia
Abstract
Mostafa A Abolfotouh,1 Mohamed A Hussein,2 Sameh M Abolfotouh,3 Alanoud Al-Marzoug,4 Suliman Al-Teriqi,5 Abeer Al-Suwailem,6 Ra’ed A Hijazi7 1Research Training and Development Section, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2Biostatistics and Bioinformatics Department King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3OrthoCure Medical Center, Dubai, UAE; 4College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 5College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia; 6College of Medicine, King Saud University, Riyadh, Saudi Arabia; 7Emergency Care Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia Background: The aim of this study was to describe the pattern of traumatic injuries and determine the predictors of inhospital mortality in patients admitted to the emergency department. Patients and methods: This is a retrospective cohort study of 3,786 patients with traumat injuries admitted to the emergency department of King Abdulaziz Medical City, Riyadh, Saudi Arabia, between January 2012 and December 2014. Data on patient characteristics, trauma characteristics and outcomes were extracted from medical records. A negative binomial regression model was utilized to identify significant predictors of inhospital mortality. Results: Of all injured patients, 77.5% were male, 29.8% were aged 15–25 years and 25.7% were aged 26–45 years. Blunt trauma was the main mechanism of injury, including motor vehicle crashes (MVCs) in 52.0% and falls in 25.8% of patients. Most patients had injuries to the extremities (61.3%), followed by the head (32.2%), chest (16.9%) and abdomen (8.9%). Injuries were mild in 49.7% of patients, moderate in 30.2% and severe in 20.1%. The sex of the patients was significantly associated with the mechanism of injury (p<0.001), severity (p<0.001), anatomical site of injury (p<0.001), admission to the intensive care unit (p<0.001), need for trauma team activation (p<0.001) and type of transportation to hospital (p<0.001). The predictors of inhospital mortality were age (rate ratio [RR] for each 10-year increase=1.174; p<0.001), falls and burns (RR=2.337 and 1.728; p<0.001) and moderate and severe injuries (RR=6.438 and 181.780; p<0.001). Conclusion: Our results suggest different patterns of trauma injuries according to patient age and sex. MVCs were the leading cause of injuries, but falls and burns had the highest inhospital mortality. This suggests the need for a comprehensive national education and prevention programs that address all causes of injuries. Keywords: MVCs, case fatality, injury severity, mechanism of injury, Saudi, causes of injury
