Our aim is to save lives, and to find out what makes a survivor.
Trauma mortality is thus the main result variable. Register death: yes/no. Also register:
- Time of death (hours after injury)
- Death on-site (before prehospital life support started): yes/no
- Death during prehospital treatment: yes/no
- In-hospital death: yes/no
Effect of prehospital life support
The aim of prehospital life support is temporary damage control, to stop physiological deterioration and even improve the physiological condition of victims. For this we compare physiological indicators on-site and again on hospital admission. RTS values are already registered at two points as explanatory variables (PEKER). From this you can construct a new result variable:
- RTS2 – RTS1.
- RTS2 ≥ RTS1 is considered good prehospital outcome.
- RTS2 ≤ RTS1 can also be used to select the subset of patients who deteriorated despite life support provided. The management of every one of these patients should be scrutinized.
Postoperative sepsis
The probability of postoperative bacterial wound infection mainly depends on the quality of primary surgical care. Still we should expect that good prehospital life support should helps reduce the rate of post-injury sepsis: bacterial wound infection and/or abscess formation and/or pneumonia and/or bacteremia. Register sepsis: yes/no
Post-injury malaria
In areas with endemic malaria Falciparum, the rate of symptomatic post-injury malaria is an indicator of treatment quality. Symptomatic malaria is defined as clinical signs of malaria (fever > 38.5 °C plus chills and sweating) and positive rapid test or microscopic smear examination. Register: post-injury malaria yes/no.
In-hospital days
The duration of the hospital treatment may be an indicator of post-injury recovery. However, this variable may be inaccurate because other factors may affect in-hospital time (actions of war, security measures, in-hospital physical rehabilitation etc.).
Gathering end-point variables
The result variables are registered at the end-point, which is the hospital providing definitive trauma surgery. Forr this we use a simple form to register the essential variables and factors.