Document Type : Original Article

Authors

1 Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

10.30491/tm.2022.357432.1507

Abstract

Background: Prevention and providing an appropriate post-injury care system are vital strategies to save substantial resources and reduce fatalities and disabilities. The present study aimed to evaluate early and late mortality risk factors.
Method: This cross-sectional study was conducted at a trauma referral center in southern Iran from June 2019 to June 2020. Based on the length of hospital stay, the patient’s outcomes were classified into short-term (within the first 48 hours of admission) and long-term (beyond 48 hours of access) categories. Predictors of mortality whose impact was evaluated included sex, age, Glasgow Coma Scale, presence of significant trauma using the Injury Severity Score, mechanism of injury, need for intubation or chest tube placement, and hospital-acquired infection.
Results: This study was performed on 1281 patients with a mean age of 37.9 ± 19.1 years. The median length of hospital stay was 7.7 days, with a mean injury severity score of 16.3 ± 11.3. The primary mechanism of injury was road-traffic accidents (65.5%), followed by falling (15.2%). During the first 48 hours of hospitalization, 217 of 1281 patients died or were discharged, so the long-term group included 1,064. The risk factors were age≥65 years (OR=5.71, CI:3.16-10.3), GCS 9-12 (OR=3.39, CI:1.55-7.42), GCS≤8 (OR=5.88, CI:3.14-11.03) major trauma (OR=1.92, CI:1.05-3.52), and chest tube insertion (OR=2.49, CI:1.4-4.43) for short-term mortality and 45-64 age group (OR=5.95, CI:3.18-11.15), age≥65 years (OR=22.12, CI:11.38-42.97), GCS 9-12 (OR=2.9, CI:1.4-6.02), GCS≤8 (OR=5.53, CI:3.03-10.11), major trauma (OR=1.99, CI:1.11-3.54), chest tube insertion (OR=2.96, CI:1.68-5.23), and incidence of hospital-acquired infection (OR=2.42, CI:1.43-4.1) for long-term mortality.
Conclusion: Despite the similarities in the predictors of short-term and long-term mortality in trauma patients, our study showed that the effect of the age of the patients in these two groups is different. To improve the prognosis of unstable trauma patients, they should be categorized based on time and age.

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