Effect of development of trauma system on outcome of major trauma patient in Prachinburi Province
Keywords:
Development of Trauma care, Mortality, Excess mortality, Door to Operating Room time, TRISS methodologyAbstract
Objective To determine the effect of development of trauma system on outcome of major trauma patient in Prachinburi Province
Methods A retrospective cohort study was conducted before development, from October 2015 to September 2016, and then after development of trauma system, from October 2016 to September 2017. The outcome measurements were mortality rate, excess mortality (the difference between observed and expected death as measured by the TRISS methodology), and Door to Operating Room (OR) time.
Results A total of 547 patients from the before-development group (BDG), and 668 patients from the after-development group (ADG) were identified.The mortality rate was significantlydecreased from 15.17% to 10.03%, and the average Door to OR time was significantlydeclined from 89.85±20.1 to 72.48±18.2 (p=0.001) in ADG. Z statistic based on TRISS methodology was 3.48 (p<0.001) in BDG and 1.98 (p=0.04) in ADG indicated that both group had excess mortality.
Conclusions Development of trauma system in Prachinburi Province significantlydecreased the mortality rate, and Door to OR time. However, the result of higher observed mortality than expected based on the TRISS methodology suggests that continuous quality improvement is necessary for improving our trauma care.
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