Epidemiological and Trauma Injury and Severity Score (TRISS) analysis of trauma patients at a tertiary care centre in India

Apul Goel, Sandeep Kumar, Manpreet K Bagga
National Medical Journal of India 2004, 17 (4): 186-9

BACKGROUND: An observational study was done to obtain the epidemiological profile of Indian trauma patients. We used the Trauma Injury and Severity Score (TRISS) and survival evaluation methodologies to compare the mortality with norms established by the Major Trauma Outcome Study of the USA to assess the quality of emergency medical care provided to trauma patients at our centre. This would allow comparisons and may help propagate the routine use of trauma scales.

METHODS: An instrument to collect detailed epidemiological and TRISS data was created and validated. All patients with trauma who were admitted to the surgery service were included in the study. The details of all patients were recorded and they were followed till discharge or death during a 6-week period.

RESULTS: Of the 180 trauma patients studied, 123 were men (70.3%) with a mean age of 24.7 years; 143 patients had blunt injuries while 32 patients had penetrating injuries. A nearly equal percentage of men were injured on the road (39.8%) as at home (39.0%), while most women (65.4%) were injured at home. The mortality rate was 31.4%. TRISS methodology was applied to 88.6% of patients. All the 113 survivors had a probability of survival > or = 0.5 and were considered expected survivors. Among the 42 deaths, 32 had a probability of survival > or = 0.5 and were considered unexpected deaths, while 10 of the deaths had a probability of survival <0.5 and were expected deaths. The reasons for the unexpected deaths were septicaemia, mannitol nephrotoxicity, aspiration and a direct result of the injury, especially in patients with burns.

CONCLUSIONS: Our centre has a high rate of unexpected deaths. Although it is the major trauma referral centre in the region, the care provided to trauma patients needs to be improved.

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