Joel Yong Hao Tan, Jiong Hao Tan, Si Heng Sharon Tan, Liang Shen, Lynette Mee-Ann Loo, Philip Iau, Diarmuid Paul Murphy, Gavin Kane O'Neill
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引用次数: 0
Abstract
Introduction: Musculoskeletal injuries are the most common reason for surgical intervention in polytrauma patients.
Methods: This is a retrospective cohort study of 560 polytrauma patients (injury severity score [ISS] >17) who suffered musculoskeletal injuries (ISS >2) from 2011 to 2015 in National University Hospital, Singapore.
Results: 560 patients (444 [79.3%] male and 116 [20.7%] female) were identified. The mean age was 44 (range 3-90) years, with 45.4% aged 21-40 years. 39.3% of the patients were foreign migrant workers. Motorcyclists were involved in 63% of road traffic accidents. The mean length of hospital stay was 18.8 (range 0-273) days and the mean duration of intensive care unit (ICU) stay was 5.7 (range 0-253) days. Patient mortality rate was 19.8%. A Glasgow Coma Scale (GCS) score <12 and need for blood transfusion were predictive of patient mortality (p < 0.05); lower limb injuries, road traffic accidents, GCS score <8 and need for transfusion were predictive of extended hospital stay (p < 0.05); and reduced GCS score, need for blood transfusion and upper limb musculoskeletal injuries were predictive of extended ICU stay. Inpatient costs were significantly higher for foreign workers and greatly exceeded the minimum insurance coverage currently required.
Conclusion: Musculoskeletal injuries in polytrauma remain a significant cause of morbidity and mortality, and occur predominantly in economically productive male patients injured in road traffic accidents and falls from height. Increasing insurance coverage for foreign workers in high-risk jobs should be evaluated.
期刊介绍:
The Singapore Medical Journal (SMJ) is the monthly publication of Singapore Medical Association (SMA). The Journal aims to advance medical practice and clinical research by publishing high-quality articles that add to the clinical knowledge of physicians in Singapore and worldwide.
SMJ is a general medical journal that focuses on all aspects of human health. The Journal publishes commissioned reviews, commentaries and editorials, original research, a small number of outstanding case reports, continuing medical education articles (ECG Series, Clinics in Diagnostic Imaging, Pictorial Essays, Practice Integration & Life-long Learning [PILL] Series), and short communications in the form of letters to the editor.