In-hospital mortality among patients injured in motor vehicle crashes in a Saudi
Arabian hospital relative to large U S trauma centers
#MMPMID26613073
Alghnam S
; Palta M
; Hamedani A
; Remington PL
; Alkelya M
; Albedah K
; Durkin MS
Inj Epidemiol
2014[]; 1
(1
): 21
PMID26613073
show ga
BACKGROUND: Traffic-related fatalities are a leading cause of premature death
worldwide. According to the 2012 report the Global Burden of Disease 2010,
traffic injuries ranked 8th as a cause of death in 2010, compared to 10th in
1990. Saudi Arabia is estimated to have an overall traffic fatality rate more
than double that of the U.S., but it is unknown whether mortality differences
also exist for injured patients seeking medical care. We aim to compare
in-hospital mortality between Saudi Arabia and the United States, adjusting for
severity and demographic variables. METHODS: The analysis included 485,611
patients from the U.S. National Trauma Data Bank (NTDB) and 5,290 patients from a
trauma registry at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia.
For comparability, we restricted our sample to NTDB data from level-I public
trauma centers (?400 beds) in the U.S. Multiple logistic regression analyses were
performed to evaluate the effect of setting (KAMC vs. NTDB) on in-hospital
mortality after adjusting for age, sex, Triage-Revised Scale (T-RTS), Injury
Severity Score (ISS), mechanism of injury, hypotension, surgery and head
injuries. Interactions between setting and ISS, and predictors were also
evaluated. RESULTS: Injured patients in the Saudi registry were more likely to be
males, and younger than those from the NTDB. Patients at the Saudi hospital were
at higher risk of in-hospital death than their U.S. counterparts. In the highest
severity group (ISSs, 25-75), the odds ratio of in-hospital death in KAMC versus
NTDB was 5.0 (95% CI 4.3-5.8). There were no differences in mortality between
KAMC and NTDB among patients from lower ISS groups (ISSs, 1-8, 9-15, and 16-24).
CONCLUSIONS: Patients who are severely injured following traffic crash injuries
in Saudi Arabia are significantly more likely to die in the hospital than
comparable patients admitted to large U.S. trauma centers. Further research is
needed to identify reasons for this disparity and strategies for improving the
care of patients severely injured in traffic crashes in Saudi Arabia.
free
free
free
