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Journal of critical care · Apr 2021
Does in-hospital trauma mortality in urban Indian academic centres differ between "office-hours" and "after-hours"?
- Kapil Dev Soni, Monty Khajanchi, Nakul Raykar, Bhakti Sarang, Gerard M O'Reilly, Satish Dharap, Peter Cameron, Naveen Sharma, Teresa Howard, Nathan Farrow, and Nobhojit Roy.
- Critical and Intensive Care, JPN Apex Trauma Centre, AIIMS, New Delhi, India.
- J Crit Care. 2021 Apr 1; 62: 31-37.
IntroductionTrauma 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.MethodRetrospective 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.Results5536 (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.ConclusionThe in-hospital mortality did not differ between trauma patients who arrived during "after-hours" compared to '"office-hours".Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
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