Outcome Analyses of Emergency Care of Trauma Patients with Reference to the Type of Injury, Treatment and Cost

Abstract

This present prospective analytic study describes the experience in the management of Orthopaedic trauma patients with reference to type of injury, type of procedure and the cost of acute care. This study was carried out at the Department of Orthopedics, Traumatology and Rehabilitation (Unit II), Mayo Hospital Lahore, from April 2001 to October 2001. This included all the patients who presented to the Accident and Emergency department of Mayo Hospital with musculoskeletal trauma. A total of 807 patients presented during this period of six months, with the mean age of 39 years and male to female ratio of 3.25:1. All the patients were resuscitated according to ATLS manual and were evaluated for further management. The commonest mode of trauma was road traffic accident (43.4%) followed by domestic accident, spot and work related injuries and violence in the percentage of 29.2,19.2 and 8.1 respectively. 94.3% of the patients presented with fractures and 5.7 with dislocations, of those with fractures 62.3% were closed and 32% were open fracture. Lower limb injuries (53.64%)were found to the commonest followed by upper limb (44.73%) and spine (1.61%). The incidence of poly trauma was found to be 7.39%. the cost of the emergency care, per patient, spend both by the hospital and by the patients himself ranges from 485/= Rupees to 4200/= rupees with an over all average of 1500/= per patient. Out of these 807 patients 49% patients were treated and discharged from the Emergency department on the same day, 45.6% of the patients were admitted for further management, 1.36% of patients, who have other associated disease, were shifted to the other departments, 0.76% were shifted to the intensive Care Unit and 3.22 patients left the Hospital against the medical advice.