Does in-hospital trauma mortality in urban Indian academic centres differ between “office-hours” and “after-hours”?

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Does in-hospital trauma mortality in urban Indian academic centres differ between “office-hours” and “after-hours”?


JournalJournal of Critical Care
Article typeJournal research article – Clinical research
Publication date – Nov – 2020
Authors – Kapil Dev Soni, Monty Khajanchi, Nakul Raykar, Bhakti Sarang, Gerard M.O’Reilly, Satish Dharap, Peter Cameron, Naveen Sharma, Teresa Howard, Nathan Farrow, Nobhojit Roy
KeywordsAfter hours, low-middle income countries, mortality, Office hours, trauma
Open access – Yes
SpecialityCritical care, Emergency surgery, Trauma and orthopaedic surgery, Trauma surgery
World region South-eastern Asia
Country: India
Language – English
Submitted to the One Surgery Index on December 16, 2020 at 11:51 am
Abstract:

Introduction
Trauma services within hospitals may vary considerably at different times across a 24 h period. The variable services may negatively affect the outcome of trauma victims. The current investigation aims to study the effect of arrival time of major trauma patients on mortality and morbidity.

Method
Retrospective analysis of the Australia-India Trauma Systems Collaboration (AITSC) registry established in four public university teaching centres in India Based on hospital arrival time, patients were grouped into “Office-hours” and “After-hours”. Outcome parameters were compared between the above groups.

Results
5536 (68.4%) patients presented “after-hours” (AO) and 2561 (31.6%) during “office-hours” (OH). The in-hospital mortality for “after-hours” and “office-hours” presentations were 12.1% and 11.6% respectively. On unadjusted analysis, there was no statistical difference in the odds of survival for OH versus AH presentations. (OR,1.05, 95% CI 0.9‐1.2). Adjusting for potential prognostic factors (injury severity, presence of shock on arrival, referral status, sex, or extremes of age), there was no statistically significant odds of survival for OH versus AH presentations (OR,1.02, 95%CI 0.9–1.2).ICU length of stay and duration of mechanical ventilation was longer in the AH group.

Conclusion
The in-hospital mortality did not differ between trauma patients who arrived during “after-hours” compared to ‘“office-hours”.

OSI Number – 20811

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