Document Detail

Trauma outcome improves following the advanced trauma life support program in a developing country.
MedLine Citation:
PMID:  8315686     Owner:  NLM     Status:  MEDLINE    
Trauma outcome variables before and after the institution of the Advanced Trauma Life Support (ATLS) program were compared for the largest hospital in Trinidad and Tobago from July 1981 through December 1985 (pre-ATLS) and from January 1986 to June 1990 (post-ATLS). A total of 199 physicians were ATLS trained by June 1990. Outcome data were analyzed for all dead or severely injured patients (ISS > or = 16; n = 413 pre-ATLS and n = 400 post-ATLS). Trauma mortality decreased post-ATLS (134 of 400 vs. 279 of 413) throughout the hospital, including the ICU (13.6% post-ATLS ICU mortality vs. 55.2% pre-ATLS). The odds of dying from trauma increased with age (1.02 for each year), ISS score (1.24 for each ISS increment), and blunt injury, both pre-ATLS and post-ATLS. Post-ATLS mortality was associated with a higher ISS (31.6 vs. 28.8). Although there was a higher percentage of blunt injury pre-ATLS (84.0%) versus post-ATLS (68.3%), the mortality rates for both blunt and penetrating injuries were higher in the pre-ATLS group (19.7% pre-ATLS vs. 6.3% post-ATLS for penetrating and 76.6% pre-ATLS versus 46.2% post-ATLS for blunt). For each ISS category, mortality was greater in the pre-ATLS group (ISS > or = 24 pre-ATLS mortality 47.9% vs. 16.7% post-ATLS; ISS 25-40 pre-ATLS mortality 91.0% vs. 71.0% post-ATLS). The overall ratio of observed to expected mortality based on the MTOS data base was lower for the post-ATLS period (pre-ATLS ratio 3.16; post-ATLS ratio 1.94).(ABSTRACT TRUNCATED AT 250 WORDS)
J Ali; R Adam; A K Butler; H Chang; M Howard; D Gonsalves; P Pitt-Miller; M Stedman; J Winn; J I Williams
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of trauma     Volume:  34     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-07-27     Completed Date:  1993-07-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  890-8; discussion 898-9     Citation Subset:  AIM; IM    
Department of Surgery, University of Toronto, Ontario, Canada.
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MeSH Terms
Age Factors
Developing Countries*
Injury Severity Score
Life Support Care* / statistics & numerical data
Middle Aged
Treatment Outcome
Trinidad and Tobago / epidemiology
Wounds and Injuries / mortality*,  therapy
Wounds, Nonpenetrating / mortality,  therapy
Wounds, Penetrating / mortality,  therapy

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