Time of admission as a prognostical factor for trauma patients

Abstract

Trauma is the leading cause of death in the population under 40 years. 60% from the total of Trauma happen in the evenings or at night, and are in the care of night staff of ICU and trauma team. The availability and quality of personnel and technology are often different during the daytime hours as compared with off hours and weekends. Our aim v/as to evaluate whether there was an association between the time of admission of trauma patients to the ICU of the National Scientifical and Practical Centre of Emergency Medicine of Chisinau, Republic of Moldova, (RM) and their prognosis. Evaluation of prognosis of trauma patients admitted to hospital at: 8. 00 - 14. 30 daytime hours (group 1); 14. 31 - 07. 59 off hours (group 2); over the weekend: from Saturday, 8. 00 to Monday 7. 59 (group 3). A retrospective study was performed. The data came from the registry of the National Scientifical and Practical Centre of Emergency Medicine of Chisinau, RM and were available from January 1, 2008 to January 1, 2009. We assessed 153 trauma patients (103 men/50 women). Estimating criteria were: evaluation of severity of trauma and prediction of outcome with (ASCOT); the survival of trauma patients; the period of treatment in ICU. The statistical analysis was performed with Statistical Package for the Social Sciences (SPSS) program. The differences of results were tested using unvaried analysis (ANOVA one - way), followed by post- hoc tests. For all the tests we applied the conventional criterion for statistical significance (p<0.05). Comparative evaluation of groups: group index sex, age, ascot, survival, admission, stay hospital, stay ICU. We have determined a statistical significantly difference for the level of survival of trauma patients between groups 1 and 2 (p<0.001), the ratio of survival for group 1 being 85% and for group 2 -54%. Between group 1 and 2 and 1 and 3 the ratio of survival doesn’t significantly differ statistically (p>0.05). The evolution (the survival) of trauma patients admitted to ICU of the National Scientifical and Practical Centre of Emergency Medicine of Chisinau, RM from January 1, 2008 to January 1, 2009 depended on their time of admission.