Trauma epidemiology in Puerto Rico: in-hospital morbidity and mortality from 2002 to 2011.

This study aimed to describe the distribution of injury mechanisms and to assess the impact of those mechanisms on the morbidity and mortality of trauma. All patients admitted to Puerto Rico Trauma Hospital (2002-2011) for road-traffic collisions (RTCs, 5,371), gunshot wounds (GSWs, 2,946), falls (2,319), pedestrian accidents (1,652), and stab wounds (SWs, 1,073) were selected. Gunshot victims were 1.19 (95%CI: 1.07-1.33) times as likely as road-traffic victims to have an ISS ≥25. Pedestrians were 1.76 (95%CI: 1.49-2.09) times more likely to have a GCS ≤8 than road-traffic victims were. The risk of dying was 2.64 (95%CI: 2.20-3.16) times higher for gunshot victims and 1.51 (95%CI: 1.23-1.86) times higher for pedestrians compared to patients who had had RTCs. Gunshot victims and pedestrians had the worst clinical outcomes. Accordingly, these patients should receive the most aggressive clinical management. Furthermore, it is imperative to develop public health campaigns on trauma prevention.