Comparison of the effectiveness of major trauma services provided by tertiary and secondary hospitals in Malaysia

Dinesh Sethi, Syed Mohamed Al-Junid Syed Junid, Saperi Sulong, Anthony B. Zwi, Hussain Hamid, Amal Nasir B Mustafa, Asaari Abdullah Abu Hassan

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The effectiveness of trauma services provided by three hospitals operating at different levels of care, district general (DGH), tertiary care, and central tertiary, were compared in Malaysia. Methods: Cases were recruited prospectively for 1 month. Outcome measures included death or, among survivors, disability at discharge. Results: Leading causes of injuries were road traffic (72%), falls (9%), industrial (6%), and assaults (5%). Fifty-nine percent of cases were direct admissions and 41% were interhospital transfers. Of the 286 direct admissions, 12% arrived by ambulance and the remainder mostly by private car. For direct admissions, logistic regression identified an increased odds of dying associated with admission to DGH (compared with central tertiary) (odds ratio [OR], 9.8; 95% confidence interval [CI], 1.3-73.7), severe injuries (Injury Severity Score > 15) (OR, 33.1; 95% CI, 7.5-146.7), and older age (≥ 55 years) (OR, 10.8; 95% CI, 2.0-56.8). Disability at discharge was associated with being severely injured (OR, 6.4; 95% CI, 2.4-17.1). Conclusion: In this study in Malaysia, admission to DGH, older age, and severe injuries are associated with increased odds of fatality.

Original languageEnglish
Pages (from-to)508-516
Number of pages9
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume53
Issue number3
Publication statusPublished - Sep 2002
Externally publishedYes

Fingerprint

Malaysia
Tertiary Care Centers
Odds Ratio
Confidence Intervals
Wounds and Injuries
Injury Severity Score
Ambulances
Tertiary Healthcare
Logistic Models
Outcome Assessment (Health Care)

Keywords

  • Developing countries
  • Effectiveness
  • Injury control
  • Malaysia
  • Trauma care

ASJC Scopus subject areas

  • Surgery

Cite this

Comparison of the effectiveness of major trauma services provided by tertiary and secondary hospitals in Malaysia. / Sethi, Dinesh; Syed Junid, Syed Mohamed Al-Junid; Sulong, Saperi; Zwi, Anthony B.; Hamid, Hussain; Mustafa, Amal Nasir B; Abu Hassan, Asaari Abdullah.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 53, No. 3, 09.2002, p. 508-516.

Research output: Contribution to journalArticle

Sethi, Dinesh ; Syed Junid, Syed Mohamed Al-Junid ; Sulong, Saperi ; Zwi, Anthony B. ; Hamid, Hussain ; Mustafa, Amal Nasir B ; Abu Hassan, Asaari Abdullah. / Comparison of the effectiveness of major trauma services provided by tertiary and secondary hospitals in Malaysia. In: Journal of Trauma - Injury, Infection and Critical Care. 2002 ; Vol. 53, No. 3. pp. 508-516.
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