Hong Kong Journal of Emergency Medicine Severely injured patients presenting to the Singapore General Hospital: a one year study

Study objectives: To determine the quantity and resource utilisation in management of the severely injured patients presenting at the Singapore General Hospital (SGH). Method: All patients who were initially triaged to the hospital Emergency Department's (ED) resuscitation room and all trauma related mortality in the year 1998 were studied. All records were traced and the cases were followed up. Important outcomes studied were mortality and length of hospital stay. Results: Three hundred and forty-seven (0.2%) severely injured patients who were initially treated at the ED's resuscitation room were studied. The median age of the patients was 32 years old. Male patients formed 82.1 % of the total. The three main causes of trauma in such patients were fall from height, motor vehicle related accidents and penetrating injuries caused by sharp instruments and firearms. Of all the patients, 62.8 % were admitted to the ED between 1601 hours to 0759 hours and 30.5 % of all severely injured patients were treated at the ED on weekends. One hundred and twenty three (35.4%) patients had emergency surgery within 24 hours of admission to the ED and 42.4 % of the patients had an ISS score of 16 or more; 22.8 % of patients had ISS score of 25 or more. The mortality of patients with ISS score of 25 or more was 39.2%. Conclusion: One percent of all new ED patients with trauma were classified as 'severely ' injured and these occurred mostly outside "normal working hours". There was significant mortality in patients with ISS score of 25 or more. (Hong Kong j.emerg.med