Patterns and Clinical Outcomes of Trauma Patients in a Tertiary Emergency Department in South India: A One-year Retrospective Study

Abstract

Trauma remains a leading cause of morbidity and mortality in India and globally. We aimed to assess the mode of trauma, injury severity, and clinical outcomes among trauma patients presenting to our emergency department (ED), and to identify factors associated with severe injury. This retrospective observational study included all trauma patients presenting to the ED between November 2022 and October 2023. Data were summarized using descriptive statistics, and multivariable logistic regression identified predictors of severe injury, reported as adjusted odds ratios (aORs) with 95% CIs ( P < 0.05). A total of 9,685 trauma cases were included. The mean age was 34 (SD 20.5) years, and 69.4% were male. Priority 2 triage was most common (51.6%), and Priority 1 accounted for 11.9%. Severe head injury (Glasgow coma scale [GCS] ≤8) occurred in 4.2% of cases. An injury severity score (ISS) ≥14 was seen in 6.2%, and new injury severity score (NISS) ≥14 in 11.6%. Road traffic accidents (RTAs) were the most common mode of trauma (50.1%), with two-wheeler incidents accounting for 77.3% of RTAs. Multivariate regression analysis showed two-wheeler use (aOR 2.80, 95% CI: 2.33–3.37), four-wheeler use (aOR 4.26, 95% CI: 3.44–5.28), pedestrian injuries (aOR 3.37, 95% CI: 1.44–7.86), and male sex (aOR 2.22, 95% CI: 1.89–2.62) as significant independent predictors of severe injury (NISS ≥14). Overall, in-hospital mortality was 0.8%. RTAs, particularly vehicular injuries, were the most frequent and severe mechanisms of trauma. Although mortality was low, the findings highlight the need for targeted prevention strategies and strengthened trauma systems.