Epidemiological Evaluation and Causes of delayed presentation of Orthopaedic polytrauma patients to Emergency Department - A Tertiary Care Centre Experience

Abstract

Introduction: Polytrauma is a leading cause of death and disability with high financial burden. The study was done with an aim to delineate specific epidemiological characteristics as well as to determine specific causes of delays of polytrauma patients in reaching emergency departments (ED). Materials and Methods: All patients with Orthopaedic polytrauma fulfilling the inclusion criteria, within a six month period were included in our study. Epidemiological data and causes of delay were tabulated and appropriate statistical analysis was done. Results: 60 patients who fulfilled the inclusion criteria were included in our study. 71.67% were male. The mean age in our series was 35.2 ± 8.34 years. Mode of trauma as per our study was 65% following road traffic accidents. 36.67% of patients were under influence of alcohol at time of injury. Patients who arrived in hospital by hired/ self-owned vehicle constituted 41.66% and rest of patients were found to arrive in Govt. run ambulance. Only 18 patients (30%) could reach the hospital in the golden hour (<1 hr.). 55% of patients sustained an injury during day time (9.00AM- 9.00PM) and 45% were injured during the night. 18.33% of patients reached the hospital late due to distance of accident from the hospital. Other major causes of late presentation included lack of finance, and traffic related delay constituting 16.67% each. Conclusion: Less than one-third of the patients presented to the emergency within 1 hour of the time of injury which stresses the need to improve prehospital care and transport in our country.