Initial Trauma Database in a University Hospital in Malaysia

Trauma is a major health problem in Malaysia. An understanding of the trauma epidemiology is important in developing a reliable trauma service. The aim of this study is to understand the pattern of trauma in our institution and to highlight the need for a dedicated trauma service. In this database, 142 cases were included. Majority were males (127, 89.4%). Most common injury types are motor vehicle accidents (87.3%) followed by falls (7.7%), and stabs (3.5%). Most Injury Severity Score (ISS) falls under moderate score with 38.7%. Mean Abbreviated Injury Score (AIS) was 3 with most involving the chest and 90% of the patients have injuries involving at least 2 regions. Average hospital length of stay (LOS) was 11.4 days ±11.5 SD; with most patients (71.8%) were discharged without permanent disability. The mortality rate was 9.2% with all having ISS>16. ISS found to be strongly related to longer hospital stay and worse outcome (0.59, p < 0.0001, 0.4, p < 0.0001). This data is equivalent to the compared registries from 4 different trauma centres. However, steps need to be taken to improve this database. In conclusion, this university hospital receives a reasonable load of trauma cases yearly which is equivalent with other trauma centres. The increasing trauma cases will benefit from an implementation of a dedicated trauma service. This trauma database needs more depth in its elements and better data handling to ensure a quality and complete registry.

[1]  H. Saidi,et al.  Preliminary data from a De Novo Trauma Registry , 2016 .

[2]  Maarten J. IJzerman,et al.  Trauma team activation varies across Dutch emergency departments: a national survey , 2015, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

[3]  M. Beuran,et al.  Trauma pattern in a level I east-European trauma center , 2015 .

[4]  M. Bukur,et al.  Does unit designation matter? A dedicated trauma intensive care unit is associated with lower postinjury complication rates and death after major complication , 2015, The journal of trauma and acute care surgery.

[5]  Joong Hwan Oh,et al.  Epidemiology of Trauma Patients and Analysis of 268 Mortality Cases: Trends of a Single Center in Korea , 2014, Yonsei medical journal.

[6]  R. M. Smith,et al.  Do trauma systems work? A comparison of major trauma outcomes between Aberdeen Royal Infirmary and Massachusetts General Hospital. , 2015, Injury.

[7]  L. Handolin,et al.  Trauma registry comparison: six-year results in trauma care in Southern Finland and Germany , 2015, European Journal of Trauma and Emergency Surgery.

[8]  M. Beuran,et al.  Trauma registry -- a necessity of modern clinical practice. , 2014, Chirurgia.

[9]  A. Exadaktylos,et al.  First results from a Swiss level I trauma centre participating in the UK Trauma Audit and Research Network (TARN): prospective cohort study. , 2014, Swiss medical weekly.

[10]  E. Mackenzie,et al.  Development and pilot implementation of a locally developed Trauma Registry: lessons learnt in a low-income country , 2013, BMC Emergency Medicine.

[11]  Grad Dip Biostat,et al.  Improved Functional Outcomes for Major Trauma Patients in a Regionalized, Inclusive Trauma System , 2012, Annals of surgery.

[12]  H. Stelfox,et al.  Indicators of the quality of trauma care and the performance of trauma systems , 2012, The British journal of surgery.

[13]  H. Eid,et al.  Towards a national trauma registry for the United Arab Emirates , 2010, BMC Research Notes.

[14]  A. McGinley,et al.  A major trauma centre is a specialty hospital not a hospital of specialties , 2009, The British journal of surgery.

[15]  C. Ursic,et al.  Improved trauma patient outcomes after implementation of a dedicated trauma admitting service. , 2009, Injury.

[16]  Rodney Judson,et al.  A statewide system of trauma care in Victoria: effect on patient survival , 2008, The Medical journal of Australia.

[17]  Daniel O Scharfstein,et al.  A national evaluation of the effect of trauma-center care on mortality. , 2006, The New England journal of medicine.

[18]  Ad Hoc Subcommittee on Outcomes.  Practice management guidelines for emergency department thoracotomy. Working Group, Ad Hoc Subcommittee on Outcomes, American College of Surgeons-Committee on Trauma. , 2001, Journal of the American College of Surgeons.

[19]  Eastman Ab,et al.  Resources for optimal care of the injured patient--1993. , 1994 .