@2024 Afarand., IRAN
ISSN: 1027-1457 Scientific Journal of Forensic Medicine 2019;25(1):23-29
ISSN: 1027-1457 Scientific Journal of Forensic Medicine 2019;25(1):23-29
Determining Survival Rate of Traffic Accident Victims and Assessing the Quality of Hospital Care in Imam Khomeini Hospital, Urmia by Using TRISS Method
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Garkaz O (1)Salari Lak Sh (*2)
Mehryar H.R (3)
Khalkhali H.R (3)
(*2) Public Health Department, Medical Sciences Faculty, Islamic Azad University, Tabriz Branch, Tabriz, Iran
(1) Epidemiology Department, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
(3) Emergency Medicine Department, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
(3) Epidemiology Department, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
Correspondence
Address: Tabriz Branch, Islamic Azad University, Soleyman Khater Street, Manzaryieh Square, Tabriz, Iran. Post Code: 5174745155.Phone: 04134799169
Fax: 04134799169
salari@iaut.ac.ir
Article History
Received: October 21, 2018Accepted: January 30, 2019
ePublished: March 19, 2019
ABSTRACT
Aims
One of the most common events is traffic accidents. Road accidents are the second death cause and age loss in the country. The aim of this study was to determine the survival rate of traffic accident victims and assessing the quality of hospital care in Imam Khomeini Hospital, Urmia by using TRISS method.
Instrument & Methods This cross sectional study was performed on 760 accident victims hospitalized to Imam Khomeini Hospital of Urmia in 2017; they were selected purposefully. Respiratory rate, systolic blood pressure, Glasgow coma scale (GCS), and the severity of injuries of the patient were collected based on the relevant expert report, and using the TRISS software, the probability of survival for patients were calculated. Z and W static were used to compare survival probability.
Findings The number of male injured individuals were 562 (73.9%) and female were 198 (26.1%). 74 (9.7%) injured individuals were between 0 and 14 years old, 437 (57.5%) individuals were between 15 and 54 years old, and 249 (32.7%) individuals were over 54 years old. The mean of RTS was 7.67±0.55 and 6.00±1.57 for the survived and non-survived individuals, respectively. The mean of the ISS was 21.62±17.63 and 56.32±25.02 for the survived and non-survived individuals, respectively. Also, the expected death was 60, and the observed death was 69.
Conclusion The number of observed deaths is more than the expected ones, indicating the low quality of hospital care.
Instrument & Methods This cross sectional study was performed on 760 accident victims hospitalized to Imam Khomeini Hospital of Urmia in 2017; they were selected purposefully. Respiratory rate, systolic blood pressure, Glasgow coma scale (GCS), and the severity of injuries of the patient were collected based on the relevant expert report, and using the TRISS software, the probability of survival for patients were calculated. Z and W static were used to compare survival probability.
Findings The number of male injured individuals were 562 (73.9%) and female were 198 (26.1%). 74 (9.7%) injured individuals were between 0 and 14 years old, 437 (57.5%) individuals were between 15 and 54 years old, and 249 (32.7%) individuals were over 54 years old. The mean of RTS was 7.67±0.55 and 6.00±1.57 for the survived and non-survived individuals, respectively. The mean of the ISS was 21.62±17.63 and 56.32±25.02 for the survived and non-survived individuals, respectively. Also, the expected death was 60, and the observed death was 69.
Conclusion The number of observed deaths is more than the expected ones, indicating the low quality of hospital care.
CITATION LINKS
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[13]Grinkevičiūtė DE, Kėvalas R, Šaferis V, Matukevičius A, Ragaišis V, Tamašauskas A. Predictive value of scoring system in severe pediatric head injury. Medicina. 2007;43(11):861-9.
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[15]Fani‐Salek MH, Totten VY, Terezakis SA. Trauma scoring systems explained. Emerg Med Aust. 1999;11(3):155-66.
[16]Abelsson A, Rystedt I, Suserud BO, Lindwall L. Mapping the use of simulation in prehospital care–a literature review. Scand J Trauma Resusc Emerg Med. 2014;22(1):22.
[17]Guzzo JL, Bochicchio GV, Napolitano LM, Malone DL, Meyer W, Scalea TM. Prediction of outcomes in trauma: anatomic or physiologic parameters? J Am Coll Surg. 2005;201(6):891-7.
[18]Boyd CR, Tolson MA, Copes WS. Evaluating trauma care: the TRISS method. Trauma score and the injury severity score. J Trauma. 1987;27(4):370-8.
[19]Deshmukh VU, Ketkar MN, Bharucha EK. Analysis of trauma outcome using the TRISS method at a tertiary care centre in Pune. Indian J Surg. 2012;74(6):440-4.
[20]Esmaeili ED, Sadeghi-Bazargani H, Vahdati SS, Shokouhi G, Safaiyan A, Lak SS. Assessment of survival and hospital care quality in patients with traffic injury in east Azerbaijan. Trauma Mon. 2017;22(5):1-6.
[21]Khosravi A, Ebrahimi H. To evaluate the outcomes of patients with trauma admitted to the Imam Hossein Hospital, Shahrood using the trauma and injury severity score (TRISS). Iran J Epidemiol. 2008;4(2):35-41. [Persian]
[22]Rodríguez JM, Peñaloza RE, Montoya JM. Road traffic injury trends in the city of Valledupar, Colombia. A time series study from 2008 to 2012. PLoS one. 2015;10(12):e0144002.
[23]Davoodi F, Hashemi Nazari SS, Ghadirzadeh MR. An Epidemiology study of road traffic accidents resulting in death: in Lorestan province in 2012. J Saf Promot Inj Prev. 2016;3(4):257-62. [Persian]
[24]Macinko J, Mullachery P, Silver D, Jimenez G, Neto OLM. Patterns of alcohol consumption and related behaviors in Brazil: Evidence from the 2013 National Health Survey (PNS 2013). PLoS One. 2015;10(7):e0134153.
[25]Baker CC, Oppenheimer L, Stephens B, Lewis FR, Trunkey DD. Epidemiology of trauma deaths. Am J Surg. 1980;140(1):144-50.
[26]Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187-96.
[27]Chawda M, Hildebrand F, Pape HC, Giannoudis PV. Predicting outcome after multiple trauma: which scoring system? Injury. 2004;35(4):347-58.
[28]Xiong L, Zhu Y, Li L. Risk factors for motorcycle-related severe injuries in a medium-sized city in China. AIMS Public Health. 2016;3(4):907-22.
[29]Masoumi K, Forouzan A, Barzegari H, Asgari Darian A, Rahim F, Zohrevandi B, et al. Effective factors in severity of traffic accident-related traumas; an epidemiologic study based on the Haddon matrix. Emergency. 2016;4(2):78-82.
[30]Azizi F, Hatami H, Janghorbani M. Epidemiology and control of common diseases in Iran. Tehran: Eshtiagh Publications; 2001. p.602-16. [Persian]
[31]Hariharan S, Chen D, Parker K, Figari A, Lessey G, Absolom D, et al. Evaluation of trauma care applying TRISS methodology in a Caribbean developing country. J Emerg Med. 2009;37(1):85-90.
[32]Talwar S, Jain S, Porwal R, Laddha B, Prasad P. Trauma scoring in a developing country. Singapore Med J. 1999;40(6):386-8.
[33]Vernon DD, Furnival RA, Hansen KW, Diller EM, Bolte RG, Johnson DG, et al. Effect of a pediatric trauma response team on emergency department treatment time and mortality of pediatric trauma victims. Pediatrics. 1999;103(1):20-4.
[34]Zafar H, Rehmani R, Raja AJ, Ali A, Ahmed M. Registry based trauma outcome: perspective of a developing country. Emerg Med J. 2002;19(5):391-4.
[35]Soltaninejad A, Fathi Ashtiani A, Ahmadi Kh, Azad Fallah P, Anisi J, Rahmati F, et al. Relationship between religious orientation and suicidal behaviors of soldiers. Islamic Life J. 2012;1(2):32-7. [Persian]
[36]Pathak SM, Jindal AK, Verma AK, Mahen A. An epidemiological study of road traffic accident cases admitted in a tertiary care hospital. Med J Armed Forces India. 2014;70(1):32-5.
[37]Saidi H, Mutiso BK, Ogengo J. Mortality after road traffic crashes in a system with limited trauma data capability. J Trauma Manag Outcomes. 2014;8(1):4.
[38]Chan CK, Yau KK, Cheung MT. Trauma survival prediction in Asian population: a modification of TRISS to improve accuracy. Emerg Med J. 2014;31(2):126-33.
[39]Chaudhry N, Naqi S, Qureshi A. Effectiveness of TRISS to evaluate trauma care in a developing country. Emerg Med J. 2012;2(7):1-4.
[40]Akhavan Akbari G, Mohammadian A. Comparison of the RTS and ISS scores on prediction of survival chances in multiple trauma patients. Acta Chir Orthop Traumatol Cech. 2012;79(6):535-9.
[41]Paffrath T, Lefering R, Flohé S, Trauma Register DGU. How to define severely injured patients?--an injury severity score (ISS) based approach alone is not sufficient. Injury. 2014;45:S64-9.
[2]Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, Mathers C. World report on road traffic injury prevention [Internet]. Geneva: World Health Organization; 2004 [cited 2011 Mar 20]. Available from: https://www.who.int/violence_injury_prevention/publications/road_traffic/world_report/en/
[3]McManus F, Waite P, Shafran R. Cognitive-behavior therapy for low self-esteem: A case example. Cogn Behav Pract. 2009;16(3):266-75.
[4]World Health Organization. The world health report 2002: reducing risks, promoting healthy life [Internet]. Geneva: World Health Organization; 2002 [cited 2004 Mar 2]. Available from: https://www.who.int/whr/2002/en/
[5]World Health Organization. Global status report on road safety 2013: supporting a decade of action [Internet]. Geneva: World Health Organization; 2013 [cited 2013 Dec 18]. Available from: https://www.who.int/violence_injury_prevention/road_safety_status/2013/en/
[6]Khademi A, Moradi S. Statistical study of traffic casualties at Norouz of 2008 in Iran (from 15 March 2008 to 3 April 2008). Iran J Forensic Med. 2009;15(1):21-8. [Persian]
[7]Zargar M, Khaji A, Karbakhsh M, Zarei MR. Epidemiology study of facial injuries during a 13 month of trauma registry in Tehran. Indian J Med Sci. 2004;58(3):109-14.
[8]Ghadirzadeh MR, Shojaei A, Khademi A, Khodadoost M, Kandi M, Alaeddini F, et al. Status and trend of deaths due to traffic accidents from 2001 to 2010 in Iran. Iran J Epidemiol. 2015;11(2):13-22. [Persian]
[9]Soori H, Ainy E, Iranfar M. Road traffic status in the world and Iran: review of results from the World Health Organization. J Saf Promot Inj Prev. 2013;1(2):53-62. [Persian]
[10]Ayni E, Soori H, Ganjali M, Le H, Baghfalaki T. Estimating cost of road traffic injuries in Iran using willingness to pay (WTP) method. PLoS One. 2014;9(12): e112721.
[11]Norouzi V, Feizi I, Vatankhah S, Pourshaikhian M. Calculation of the probability of survival for trauma patients based on trauma score and the injury severity score model in Fatemi hospital in Ardabil. Arch Trauma Res. 2013;2(1):30-5.
[12]Spence MT, Redmond AD, Edwards JD. Trauma audit--the use of TRISS. Health Trends. 1988;20(3):94-7.
[13]Grinkevičiūtė DE, Kėvalas R, Šaferis V, Matukevičius A, Ragaišis V, Tamašauskas A. Predictive value of scoring system in severe pediatric head injury. Medicina. 2007;43(11):861-9.
[14]Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flanagan ME. A revision of the trauma score. J Trauma. 1989;29(5):623-9.
[15]Fani‐Salek MH, Totten VY, Terezakis SA. Trauma scoring systems explained. Emerg Med Aust. 1999;11(3):155-66.
[16]Abelsson A, Rystedt I, Suserud BO, Lindwall L. Mapping the use of simulation in prehospital care–a literature review. Scand J Trauma Resusc Emerg Med. 2014;22(1):22.
[17]Guzzo JL, Bochicchio GV, Napolitano LM, Malone DL, Meyer W, Scalea TM. Prediction of outcomes in trauma: anatomic or physiologic parameters? J Am Coll Surg. 2005;201(6):891-7.
[18]Boyd CR, Tolson MA, Copes WS. Evaluating trauma care: the TRISS method. Trauma score and the injury severity score. J Trauma. 1987;27(4):370-8.
[19]Deshmukh VU, Ketkar MN, Bharucha EK. Analysis of trauma outcome using the TRISS method at a tertiary care centre in Pune. Indian J Surg. 2012;74(6):440-4.
[20]Esmaeili ED, Sadeghi-Bazargani H, Vahdati SS, Shokouhi G, Safaiyan A, Lak SS. Assessment of survival and hospital care quality in patients with traffic injury in east Azerbaijan. Trauma Mon. 2017;22(5):1-6.
[21]Khosravi A, Ebrahimi H. To evaluate the outcomes of patients with trauma admitted to the Imam Hossein Hospital, Shahrood using the trauma and injury severity score (TRISS). Iran J Epidemiol. 2008;4(2):35-41. [Persian]
[22]Rodríguez JM, Peñaloza RE, Montoya JM. Road traffic injury trends in the city of Valledupar, Colombia. A time series study from 2008 to 2012. PLoS one. 2015;10(12):e0144002.
[23]Davoodi F, Hashemi Nazari SS, Ghadirzadeh MR. An Epidemiology study of road traffic accidents resulting in death: in Lorestan province in 2012. J Saf Promot Inj Prev. 2016;3(4):257-62. [Persian]
[24]Macinko J, Mullachery P, Silver D, Jimenez G, Neto OLM. Patterns of alcohol consumption and related behaviors in Brazil: Evidence from the 2013 National Health Survey (PNS 2013). PLoS One. 2015;10(7):e0134153.
[25]Baker CC, Oppenheimer L, Stephens B, Lewis FR, Trunkey DD. Epidemiology of trauma deaths. Am J Surg. 1980;140(1):144-50.
[26]Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187-96.
[27]Chawda M, Hildebrand F, Pape HC, Giannoudis PV. Predicting outcome after multiple trauma: which scoring system? Injury. 2004;35(4):347-58.
[28]Xiong L, Zhu Y, Li L. Risk factors for motorcycle-related severe injuries in a medium-sized city in China. AIMS Public Health. 2016;3(4):907-22.
[29]Masoumi K, Forouzan A, Barzegari H, Asgari Darian A, Rahim F, Zohrevandi B, et al. Effective factors in severity of traffic accident-related traumas; an epidemiologic study based on the Haddon matrix. Emergency. 2016;4(2):78-82.
[30]Azizi F, Hatami H, Janghorbani M. Epidemiology and control of common diseases in Iran. Tehran: Eshtiagh Publications; 2001. p.602-16. [Persian]
[31]Hariharan S, Chen D, Parker K, Figari A, Lessey G, Absolom D, et al. Evaluation of trauma care applying TRISS methodology in a Caribbean developing country. J Emerg Med. 2009;37(1):85-90.
[32]Talwar S, Jain S, Porwal R, Laddha B, Prasad P. Trauma scoring in a developing country. Singapore Med J. 1999;40(6):386-8.
[33]Vernon DD, Furnival RA, Hansen KW, Diller EM, Bolte RG, Johnson DG, et al. Effect of a pediatric trauma response team on emergency department treatment time and mortality of pediatric trauma victims. Pediatrics. 1999;103(1):20-4.
[34]Zafar H, Rehmani R, Raja AJ, Ali A, Ahmed M. Registry based trauma outcome: perspective of a developing country. Emerg Med J. 2002;19(5):391-4.
[35]Soltaninejad A, Fathi Ashtiani A, Ahmadi Kh, Azad Fallah P, Anisi J, Rahmati F, et al. Relationship between religious orientation and suicidal behaviors of soldiers. Islamic Life J. 2012;1(2):32-7. [Persian]
[36]Pathak SM, Jindal AK, Verma AK, Mahen A. An epidemiological study of road traffic accident cases admitted in a tertiary care hospital. Med J Armed Forces India. 2014;70(1):32-5.
[37]Saidi H, Mutiso BK, Ogengo J. Mortality after road traffic crashes in a system with limited trauma data capability. J Trauma Manag Outcomes. 2014;8(1):4.
[38]Chan CK, Yau KK, Cheung MT. Trauma survival prediction in Asian population: a modification of TRISS to improve accuracy. Emerg Med J. 2014;31(2):126-33.
[39]Chaudhry N, Naqi S, Qureshi A. Effectiveness of TRISS to evaluate trauma care in a developing country. Emerg Med J. 2012;2(7):1-4.
[40]Akhavan Akbari G, Mohammadian A. Comparison of the RTS and ISS scores on prediction of survival chances in multiple trauma patients. Acta Chir Orthop Traumatol Cech. 2012;79(6):535-9.
[41]Paffrath T, Lefering R, Flohé S, Trauma Register DGU. How to define severely injured patients?--an injury severity score (ISS) based approach alone is not sufficient. Injury. 2014;45:S64-9.