An audit of patients presenting with trauma to a tertiary care medical centre

Pradheep, M (2018) An audit of patients presenting with trauma to a tertiary care medical centre. Masters thesis, Thanjavur Medical College, Thanjavur.


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INTRODUCTION: Motor Vehicle Accidents (MVAs) is an issue of national concern, considering its magnitude and gravity and the consequent negative impacts on the economy, public health and the general welfare of the people. World Health Statistics 2008 cited in Global Status Report on Road Safety states that MVAs in 2004 were the 9th leading cause of death and at current rates by 2030 are expected to be the 5th leading cause of death, overtaking diabetes and Human immunodeficiency virus infection/acquired immunodeficiency syndrome. In its last report, World Health Organization (WHO) has expressed the need for more research on the epidemiologic pattern of MVA in low and middle income countries to determine the dimensions of the problem. AIMS AND OBJECTIVES: 1. To evaluate the age and sex incidence of the involved patient population. 2. To evaluate the different organ systems involved. 3. To correlate the eventual mortality with the type of injury sustained. INCLUSION CRITERIA: 1. Patients who are admitted to Thanjavur Medical College Hospital following Motor Vehicle Accident. 2. Patients with significant injury following Motor Vehicle Accident. 3. Patients of both sexes and all age groups. EXCLUSION CRITERIA: 1. Patients who were not willing for study. Study Design: Prospective study. Study Period: 01.10.2016 - 30.03.2017. Study Place: Thanjavur Medical College Hospital, Thanjavur STUDY METHODOLOGY: The study is a prospective analysis of cases of MVAs victims admitted in Thanjavur Medical College, Tamilnadu during the period between 2016 October to 2017 March after getting ethical clearance. Case sheets of MVAs victims from the medical records sections were read and the necessary details were sought in terms of age, sex, residence, alcohol intake, type and site of injury and mortality. The cases with incomplete details were not taken into consideration. OBSERVATIONS AND RESULTS: 716 patients presenting with injuries sustained in MVAs were included in the study and analysed. The patient's age ranged from 4 to 85 years with the mean age being 30.91 years. The most common type of collision was two wheeler to two wheeler collision was 313 (43.7%) was most common form among the causes observed, followed by collision of four wheeler to pedestrian (19.5%). Head injuries 326 (45.5%) were the most common region injured followed by extremities – 264 cases (36.8%). Among extremities, injuries were more common in the lower limb – 177 cases (66.4%). In upper limb fractures, isolated radius – 46 cases (54.76%) was most commonly involved followed by both radius and ulna in 22 cases (25.19%). In lower limb fractures, both tibia and fibula were commonly involved in 81 cases (48.79%) followed by femur in 28 cases (16.86%) and isolated tibia in 21 cases (12.65%). 2 cases involving popliteal artery injury and 1 case involving radial artery injury were reported. Head injury was the commonest form of internal injuries seen in victims which was observed in 326 victims, showing clinical symptoms like unconsciousness, ENT bleed, vomiting, and nausea. 86 patients had torso injury of which 57 involved chest injuries (66.2%) and remaining 29 involved abdominal injury (33.8%). 8 patients had spinal injury presenting with weakness of limbs. Out of which 7 had cervical spine injury and 1 had dorso-lumbar spine injury. Among facial injuries, fractures were common in maxilla followed by zygoma. Among the 716 patients, 89 patients (12.4%) expired. 28 (31.4%) of them were among the productive age group of 30 – 39 years. 80 patients (89%) with head injury followed by 4 cases of cervical spine injury and 3 cases (7.5%) with abdominal injury were the leading causes of death. Among head injury, SDH was found to be the most common cause of death followed by ICH. Among abdominal injuries, hollow viscus perforation was found to be major cause of death. Two cases of femur fracture also expired. CONCLUSION: • Improving emergency medical services may prevent untimely deaths and disabilities caused by RTAs. • Alcohol intake proves to be an important risk factor in cases of MVAs. • The most common age group was found to be 30-39 years, especially males. • Head injuries were the most common injuries in MVAs. • Head injury was the major cause of death in motor vehicle accidents. • Death was more common among males, especially belonging to age group 30-39 years. • MVAs continue to be an increasing trend as one of the major preventable causes of death.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Motor Vehicle Accidents ; Head injury ; Fracture ; Haemothorax ; Pneumothorax ; Intracranial haemorrhage ; Abdominal injury ; Spine injury ; Facial injury.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 10 Sep 2018 15:44
Last Modified: 10 Sep 2018 15:44

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