A prospective observational study of assessment of morbidity & mortality pattern in trauma cases in a tertiary care hospital

Abstract

Introduction: Trauma is the study of medical problems associated with physical injury. The injury is the adverse effect of a physical force upon a person. There are a variety of forces that can lead to injury, however the force involved in most injuries is mechanical. The subject of trauma therefore centers upon the deleterious effects of kinetic energy on the human frame. The main objective of this study is to assess the morbidity & mortality in such cases of trauma by using NISS check association between NISS and outcome of patients. Correlation Coefficient will be obtained to check relationship between NISS and time post admission. Materials and Methods: This study is prospective observational study follow up after 1 and 2 month. All the patients presenting to emergency department will be admitted and initial resuscitation done. Investigation such as X-ray chest, abdomen and pelvis, both hips, USG chest & abdomen will be done apart from other Routine Investigations. Preliminary data for each patient will be first Recorded in the trauma data collection form, which will also accompany the patients clinical Record. This single sheet form contains the patient’s vital information and physiological data gathered by rescuers at the scene of the accident. Data on this form will be updated daily and all injury diagnoses will be recorded and calculated from which New injury severity score (NISS) obtained for every single patients and mortality & morbidity in each case will be assessed by using the softwear Microsoft Excel. Results: The most common age group involved was 21- 30 years [46.09%] followed by 11-20 years [16.7%] The incidence reduced sharply after 40 years. Most of the study population was males 287 [77.36%]. Out of 371 cases, majority sustained head injury 127 [34.23%] followed by blunt abdominal trauma 95 [25.6%], stab injuries were seen in 69 [18.6 %] cases and 63 [16.9%] cases suffered assault. Total 78 [21.02%] cases died. Majority of the deaths occurred after 72 hours of admission 18 [23.1%] and 12 [15.4%] deaths happened within 1 hour of admission. Seventeen [21.8%] deaths occurred between 24-72 hours of admission. Conclusion: The NISS and ISS system of scoring was applied on the entire trauma cases of this study, it was found that NISS has excellent predictive ability for hazardous outcome [death] which is better than ISS. The NISS takes after the ISS in its simplicity and ease of computation while increasing its ability to deal with multiple injuries. In a more severely injured population, with a higher proportion of multiple injuries caused by penetrating trauma, the NISS would clearly outperform the ISS.