Evolution of trauma management at a tertiary care hospital: A cohort study

Document Type



Orthopaedic Surgery; Paediatrics and Child Health; Neurosurgery; Surgery


Objective: To analyze the characteristics of polytrauma Patients and to assess the outcome of trauma care as this specialty has evolved over the years at a university hospital.
Methods: The study included all polytrauma Patients treated between January 1998 and September 2005 at a tertiary care hospital in a megacity. Data of 1009 Patients was collected prospectively and analyzed retrospectively. Patients were divided into two groups A and B, based on their presentation before and after the introduction of a formal trauma training course in 2002. The analysis included demographic data, injury severity score, vital signs including hemodynamics and GCS on admission, intubation rates, mortality and complications.
Results: 435 Patients were included in group A (1998-2001) whereas group B (2002-2005) comprised of 574 Patients. The proportion of Patients with accidental versus intentional injuries was similar in both groups. The mean injury severity score of group A was 11.9 whereas that of group B was 11.7. Almost 50% of Patients were transferred from other hospitals. Transferred Patients had significantly lower GCS (p< 0.05).
Conclusions: This study supports the view that as trauma care evolved at our hospital with the establishment of a formal training program, the mortality rates have significantly decreased.

Publication (Name of Journal)

International Journal of Surgery