Comparison of trauma mortality between two hospitals in Turkey to one trauma center in the US.

Objectives: The development of comprehensive international trauma case registries could be used to perform outcomes analysis and comparisons between countries with the goal of improving trauma care worldwide.

Methods: A retrospective study (April 2004 to April 2005) of injured patients from a Pennsylvania state trauma center (PSTC) were case matched according to age, sex, and injury severity score with two Turkish hospitals. Patients' demographics (age, sex), prehospital information (mechanism of injury, mode of transportation), injury severity (injury severity score and Glasgow coma score), and outcomes (intensive care unit length of stay, hospital length of stay, mortality) were collected.

Statistical Analysis: P value of less than 0.05, odds ratio (OR), chi2 test, two-sample t-test, mean+/-SD.

Results: Medical records from 506 Turkish trauma patients were abstracted and compared with 506 injured patients in the PSTC registry. Patients in Turkey presented more commonly with a Glasgow coma score of less than or equal to 8 (13.09 vs. 4.26%, P<0.01, OR 3.38) had increased mortality (8.30 vs. 0.79%, P<0.01, OR 11.36) and required mechanical ventilation more than 1 day more often (16.44 vs. 8.75%, P<0.01, OR 2.05). Motor vehicle crashes were the leading cause of injury in both groups. Assaults and falls were more frequent in the PSTC. Pedestrian injuries were more common and had higher mortality rates in Turkey (P<0.05).

Conclusion: This study demonstrates significantly worse outcomes in trauma care and higher mortality rates in Turkey versus PSTC. Developing a trauma registry to monitor improvements in patient care and to target injury prevention strategies should be a high priority for the Turkish healthcare system.