Injury surveillance at a level I trauma centre in Johannesburg, South Africa: research

An analysis of 16 357 trauma patients seen over a one year period at the trauma casualty of an academic hospital in Johannesburg was carried out to determine the profile of injuries sustained by victims in the Johannesburg region. A retrospective survey was conducted between January and December 2001 to compile a composite trauma morbidity and mortality profile, and to create baseline data for future comparison. The objectives of the survey were: to describe the frequencies, distribution and categories of injuries; to assess, on admission to the trauma casualty, the severity of injuries according to the TRISS method; and the outcomes and/or placement of patients after initial treatment in the trauma casualty. Guided by a structured checklist, data were collected by reviewing trauma registers and patients' documents. The TRISS method was used to determine injury severity and descriptive statistics were used to present and describe the results. A preview of the survey results indicates that males are a high-risk category for trauma, particularly over weekends, during their nocturnal activities. More than two thirds of all patients sorted in the 16-35 year age group. Injuries to the limbs and head and neck regions accounted for the highest percentage of cases with assault or interpersonal violence a major cause in an estimated 70% of cases. More than 60% of a random sample of 163 patients had sustained serious injuries with an ISS between 16 and 75; the majority however had a survival probability (Ps) of > 50%. This paper describes the methodology and results of the survey in relation to a proposed long-term injury surveillance project. 'n Analise van 16 357 trauma-pasiënte gesien in 'n een-jaar periode in die trauma-ongevalle van 'n akademiese hospitaal in Johannesburg, is uitgevoer ten einde 'n profiel van beserings wat opgedoen is deur slagoffers, in die Johannesburg-area, te bepaal. 'n Retrospektiewe opname is gebruik om 'n omvattende trauma-morbiditeit en mortaliteitsprofiel saam te stel, en om basislyndata vir toekomstige vergelykings te genereer. Die fokus van die opname was gerig op frekwensie, verspreiding en kategorisering van beserings, die ernstigheidsgraad van beserings (ISS), asook die uitkoms en plasing van pasiënte na inisiële behandeling in die trauma-ongevalle. 'n Gestruktureerde kontrolelys is gebruik om data te versamel deur die evaluering van traumaregisters en dokumentasie van pasiënte. Die TRISS-metode is gebruik om te bepaal wat die ernstigheidsgraad van die beserings was. Verder is beskrywende statistiek gebruik om die data aan te bied en te beskryf. Die resultate van die opname dui aan dat mans in die hoërisiko-kategorie vir trauma val, veral tydens naweke en gedurende nagtelike aktiwiteite. Meer as tweederdes van alle pasiënte val in die 16- 35 jaar ouderdomsgroep. Beserings aan die ledemate, kop- en nekarea het in die meeste gevalle voorgekom. In ongeveer 70% van die gevalle was aanranding of interpersoonlike geweld die hoofoorsaak van hierdie beserings. Meer as 60% van 'n ewekansige steekproef van 163 pasiënte het ernstige beserings opgedoen, met 'n ISS van tussen 16 en 75. Die meerderheid het egter 'n oorlewingsmoontlikheid (Ps ) van > 50% gehad. Hierdie artikel beskryf die metodologie en resultate van die opname in die konteks van 'n voorgestelde projek vir die waarneming van langtermynbeserings. (Health SA Gesondheid: interdisciplinary research journal: 2003 8(3): 3-12