A Cohort Study: Prognostic Value of the Primary GCS, Mechanism and Severity of Trauma and In the Outcome of Multiple-Trauma Patients

Abstract

Trauma is one of the major causes of death and disability worldwide, and a high percentage of trauma patients die of their injuries before reaching the hospital. Various factors in the scene and in emergency room can affect the outcome. The aim of this study was to determine the relationship between the mechanism of trauma and primary GCS with the mortality rate of trauma patients referred to a trauma center in west of Iran from 2019 to 2021. In this retrospective study all multiple trauma patients who referred to our emergency department from 2019 to 2014 were included. Demographic and clinical information was extracted from patient data file. The data were analyzed using SPSS v25. Of 2876 patients included, 73.7% were men. The most common cause of trauma was road traffic collisions (1121 cases). The second most mechanism was falling (1104 cases), 307 cases were injured by stab wounds, 197 cases had blunt injuries and 65 cases were traumatized by firearms. The rest of cases had unknown mechanisms. There was a significant difference between the mechanism of trauma in the two groups of deceased and non-deceased cases. In this study, out of 2876 trauma patients, 21 patients had a GCS less than 8, and 8 of them died. In patients with GCS of less than 8 and equal or more than 8, 38.1% and 1.4% of patients died respectively. There was a significant difference between the GCS of two groups of deceased and non-deceased patients. Based on our study, there was a significant relationship between the mechanism of trauma and initial GCS with the rate of mortality in critical trauma patients. More advanced therapeutic interventions by EMS personnel in patients with reduced consciousness and preventive measures to reduce collisions could reduce the resulting burden on the health system.