Mortality after Major trauma – An analysis of the factors that impacts Trauma Survivorship between India and the United Kingdom

Abstract

Background: Major trauma following road traffic accidents (RTA) is the largest cause of death and permanent disability in children and adults below 40 years of age worldwide. Various factors at both a pre-hospital and in-hospital settings play a major role in the survivorship. This study critically evaluated and suggested changes that could potentially improve the survivorship of patients based on the provision of pre-hospital and in-hospital care.

Methods: We researched epidemiological, economical, mortality and injury figures following RTAs in India and the UK and compared their trends from 2000-2015. We also analysed the factors that could have influenced the mortality rates, including the pre-hospital and in-hospital care in these two countries and emphasised the role of various factors that influences the post injury mortality rate.

Results: In the UK, the number of RTA injuries recorded in 2000 was 320,000. This decreased by 41.8% to 186,189 in 2015. The number of RTA associated deaths recorded in the UK in 2000 was 3409, decreased by 49.2% to 1730 in 2015. The establishment of trauma networks contributed to significant reduction in mortality in the UK. In India, the number of RTA injuries recorded in 2000 was 399,265 and this increased by 20.8% in 2015 to 482,389. However the number of RTA associated deaths in India increased exponentially by 88.5% from 78,911 in 2000 to 148,707 in 2015.

Conclusion: Our study revealed the exponential increase in mortality rate when compared to the number of injuries and highlighted the need for improving pre-hospital and in-hospital care India. The lessons learnt from the UK, especially with setting up of trauma networks, focussed training and establishment of major trauma centres, could bring a significant improvement in the survival rate of this young productive population in India. Though there is a long way to achieve the target set by ‘Brazilia Declaration’, India being a signatory has an obligation to its citizens and the world to reach the target.