Epidemiology, Clinical Outcomes, and Emergency Department Utilization Among Trauma Patients in Northern Iran: A Retrospective Cross-Sectional Study
TL;DR
The findings underscore the necessity for targeted preventive measures aimed at young adult drivers and the expeditious delivery of therapeutic interventions, such as wound care and fracture immobilization, to reduce ED LOS.
Abstract
Objective: This study aimed to investigate the epidemiological characteristics, clinical outcomes, and emergency department (ED) utilization patterns among trauma patients in northern Iran. Methods: This retrospective cross-sectional study was conducted in northern Iran from January 2021 to December 2023. Systematic random selection was used to choose 2,350 trauma patients from the hospital's electronic health record (EHR) system. Data regarding demographic, trauma-related characteristics, clinical outcomes, and ED utilization were extracted from the EHR. Descriptive statistics and inferential analyses, including Chi-square and independent t-tests, were used to examine factors associated with patient outcomes. Results: Trauma-related mortality was significantly associated with the 19-39-year age group, marital status, severe head injury (indicated by a low Glasgow Coma Scale score), driver status, and early-morning accidents (all p<0.001). Prolonged ED length of stay (LOS; >6 hours) was significantly associated with therapeutic procedures, including fracture immobilization, fixation, wound dressing, arterial blood gas analysis, and oxygen therapy. Conversely, diagnostic imaging (CT scans and sonography) showed no significant independent effect on ED LOS. The most common ED interventions were fracture immobilization (96.8%), sonography (85.1%), and CT scans (77.5%). Prolonged LOS in the ED was strongly associated with therapeutic procedures such as fixation, wound dressing, arterial blood gas analysis, and oxygen therapy, whereas diagnostic imaging showed no significant effect. Conclusion: The findings underscore the necessity for targeted preventive measures aimed at young adult drivers and the expeditious delivery of therapeutic interventions, such as wound care and fracture immobilization, to reduce ED LOS. These region-specific insights regarding emergency service utilization are essential for trauma system planning in resource-limited settings.