Characters of Mortality and Time Series Analysis in Thoracic Injury Before and After Rapid Response Trauma Team Establishment
Keywords:
Maxillofacial injury, Mortality, Multiple injuries, Rapid response trauma team, Time series analysis, Thoracic injuryAbstract
Background: Severe thoracic injury is a life threatening condition and needs prompt as well as proper treatment. The Department of Surgery, Faculty of Medicine, Chiang Mai University has established the Rapid Response Trauma Team (RRTT) in July 2006. The aim of this study was to verify mortality rate alteration after setting up the RRTT.
Methods: We performed a retrospective “before and after” designed study between January 2004 and September 2009. The month before July 2006 was defined as “before RRTT” and after was “after RRTT”. Monthly mortality rate, severity injury score (ISS) and demographic data were collected.
Results: A total of 951 patients were included [427 (30 months) in before RRTT and 524 (39 months) in after RRTT]. Of these, 83 patients (8.8%) died after admission and were analyzed for characteristics of mortality. The average age of mortality cases was 38.7 ± 16.3 years. Male was a predominant gender. The most common mechanism of injury was motor cycle accident. Although there were no difference of characters and mechanisms of injuries between two periods but patients associated with maxillofacial injury had significant lower mortality in after RRTT (28.5% vs. 10.5%; p = 0.04). The after RRTT group had a significantly higher occurrence of urinary complication and acute renal failure. The average adjusted monthly mortality rate was lower in after RRTT (9.0 ± 6.1 vs. 6.9 ± 4.0%). Time series analysis between two periods demonstrated a trend towards decrease in monthly mortality after RRTT [coefficient(95% CI) = -0.61(-1.13 to -0.23); p<0.01)].
Conclusion: The RRTT establishment could decrease mortality rate. The protective effect was predominant in patients associated with maxillofacial injuries.
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