Comparison of trauma management between two major trauma services in Riyadh, Kingdom of Saudi Arabia and Melbourne, Australia. Issue 5 (18th May 2021)

• Record Type: Journal Article
• Authors: Alsenani, Mohammad; A Alaklobi, Faisal; Ford, Jane; Earnest, Arul; Hashem, Waleed; Chowdhury, Sharfuddin; Alenezi, Ahmed; Fitzgerald, Mark; Cameron, Peter
• Is Part Of: BMJ open. Volume 11:Issue 5(2021)
• Publication Date: 2021-05-18
• Subjects: epidemiology -- health informatics -- public health -- trauma management -- quality in healthcare -- information management; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-045902
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Introduction: The burden of injury in the Kingdom of Saudi Arabia (KSA) has increased in recent years, but the country has lacked a consistent methodology for collecting injury data. A trauma registry has been established at a large public hospital in Riyadh from which these data are now available. Objectives: We aimed to provide an overview of trauma epidemiology by reviewing the first calendar year of data collection for the registry. Risk-adjusted analyses were performed to benchmark outcomes with a large Australian major trauma service in Melbourne. The findings are the first to report the trauma profile from a centre in the KSA and compare outcomes with an international level I trauma centre. Methods: This was an observational study using records with injury dates in 2018 from the registries at both hospitals. Demographics, processes and outcomes were extracted, as were baseline characteristics. Risk-adjusted endpoints were inpatient mortality and length of stay. Binary logistic regression was used to measure the association between site and inpatient mortality. Results: A total of 2436 and 4069 records were registered on the Riyadh and Melbourne databases, respectively. There were proportionally more men in the Saudi cohort than the Australian cohort (86% to 69%). The Saudi cohort was younger, the median age being 36 years compared with 50 years, with 51% of injuries caused by road traffic incidents. The risk-adjusted length of stay was 4.4 days less at the Melbourne hospital (95% CI 3.95 days to 4.86 days, p<0.001). The odds of in-hospital death were also less (OR 0.25; 95% CI 0.15 to 0.43, p<0.001). Conclusions: This is the first hospital-based study of trauma in the kingdom that benchmarks with an individual international centre. There are limitations to interpreting the comparisons, however the findings have established a baseline for measuring continuous improvement in outcomes for KSA trauma services.