Prashant Bhandarkar1,2, Priti Patil1, Kapil Dev Soni3, Gerard M O'Reilly4,5, Satish Dharap6, Joseph Mathew4, Naveen Sharma7, Bhakti Sarang1, Anita Gadgil1, Nobhojit Roy8,9,10. 1. Trauma Research Group, WHO Collaborating Centre for Research in Surgical Care Delivery in LMICs, Mumbai, India. 2. School of Health System Studies, Tata Institute of Social Sciences, Mumbai, India. 3. Critical and Intensive Care, JPN Apex Trauma Centre, AIIMS, New Delhi, India. 4. National Trauma Research Institute, The Alfred, Melbourne, Australia. 5. School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia. 6. Topiwala National Medical College & B.Y.L. Nair Ch. Hospital, Mumbai, India. 7. Department of Surgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, India. 8. Trauma Research Group, WHO Collaborating Centre for Research in Surgical Care Delivery in LMICs, Mumbai, India. nobhojit.roy@ki.se. 9. Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden. nobhojit.roy@ki.se. 10. School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia. nobhojit.roy@ki.se.
Abstract
BACKGROUND: India has one-sixth (16%) of the world's population but more than one-fifth (21%) of the world's injury mortality. A trauma registry established by the Australia India Trauma Systems Collaboration (AITSC) Project was utilized to study 30-day in-hospital trauma mortality at high-volume Indian hospitals. METHODS: The AITSC Project collected data prospectively between April 2016 and March 2018 at four Indian university hospitals in New Delhi, Mumbai, and Ahmedabad. Patients admitted with an injury mechanism of road or rail-related injury, fall, assault, or burns were included. The associations between demographic, physiological on-admission vitals, and process-of-care parameters with early (0-24 h), delayed (1-7 days), and late (8-30 days) in-hospital trauma mortality were analyzed. RESULTS: Of 9354 patients in the AITSC registry, 8606 were subjected to analysis. The 30-day mortality was 12.4% among all trauma victims. Early (24-h) mortality was 1.9%, delayed (1-7 days) mortality was 7.3%, and late (8-30 days) mortality was 3.2%. Abnormal physiological parameters such as a low SBP, SpO2, and GCS and high HR and RR were observed among non-survivors. Early initiation of trauma assessment and monitoring on arrival was an important process of care indicator for predicting 30-day survival. CONCLUSIONS: One in ten admitted trauma patients (12.4%) died in urban trauma centers in India. More than half of the trauma deaths were delayed, beyond 24 h but within one week following injury. On-admission physiological vital signs remain a valid predictor of early 24-h trauma mortality.
BACKGROUND: India has one-sixth (16%) of the world's population but more than one-fifth (21%) of the world's injury mortality. A trauma registry established by the Australia India Trauma Systems Collaboration (AITSC) Project was utilized to study 30-day in-hospital trauma mortality at high-volume Indian hospitals. METHODS: The AITSC Project collected data prospectively between April 2016 and March 2018 at four Indian university hospitals in New Delhi, Mumbai, and Ahmedabad. Patients admitted with an injury mechanism of road or rail-related injury, fall, assault, or burns were included. The associations between demographic, physiological on-admission vitals, and process-of-care parameters with early (0-24 h), delayed (1-7 days), and late (8-30 days) in-hospital trauma mortality were analyzed. RESULTS: Of 9354 patients in the AITSC registry, 8606 were subjected to analysis. The 30-day mortality was 12.4% among all trauma victims. Early (24-h) mortality was 1.9%, delayed (1-7 days) mortality was 7.3%, and late (8-30 days) mortality was 3.2%. Abnormal physiological parameters such as a low SBP, SpO2, and GCS and high HR and RR were observed among non-survivors. Early initiation of trauma assessment and monitoring on arrival was an important process of care indicator for predicting 30-day survival. CONCLUSIONS: One in ten admitted traumapatients (12.4%) died in urban trauma centers in India. More than half of the trauma deaths were delayed, beyond 24 h but within one week following injury. On-admission physiological vital signs remain a valid predictor of early 24-h trauma mortality.
Authors: Gowri Shivasabesan; Gerard M O'Reilly; Joseph Mathew; Mark C Fitzgerald; Amit Gupta; Nobhojit Roy; Manjul Joshipura; Naveen Sharma; Peter Cameron; Madonna Fahey; Teresa Howard; Zoe Cheung; Vineet Kumar; Bhavesh Jarwani; Kapil Dev Soni; Pankaj Patel; Advait Thakor; Mahesh Misra; Russell L Gruen; Biswadev Mitra Journal: World J Surg Date: 2019-10 Impact factor: 3.352
Authors: Nobhojit Roy; Martin Gerdin; Samarendra Ghosh; Amit Gupta; Vineet Kumar; Monty Khajanchi; Eric B Schneider; Russell Gruen; Göran Tomson; Johan von Schreeb Journal: World J Surg Date: 2016-06 Impact factor: 3.352
Authors: Kundavaram Paul Prabhakar Abhilash; Nilanchal Chakraborthy; Gautham Raja Pandian; Vineet Subodh Dhanawade; Thomas Kurien Bhanu; Krishna Priya Journal: J Family Med Prim Care Date: 2016 Jul-Sep