Comparative Analysis of Two Different Turkish Hospital Reports on Polytrauma Patients with Thoracic Trauma

Abstract

BACKGROUND: The present study aims to assess whether there are any differences in the management and outcome of polytrauma patients with thoracic trauma in trauma units of two different hospitals in the same country; one hospital is near the Syrian border. METHODS: A retrospective analysis (January 2012 to January 2014) of 348 polytrauma casualties with thoracic trauma from Manisa Celal Bayar University Hospital (MH) were compared according to age, gender, mechanism of injury, associated injuries, abbreviated injury scale (AIS), injury severity score (ISS), treatment modalities, and mortality with 917 patients of Sanliurfa Training and Research Hospital (SH) registry (near the Syrian border). RESULTS: Of the 348 patients in the MH, 230 (66%) and of the 917 patients in the SH, 697 (76%) were males (p<0.001). Mean age was 45.6 +/- 18.3 yrs in the MH group and 26.4 +/- 22.4 yrs in the SH group (p<0.001). The SH patients had a larger proportion of stab wounds (MH; 9% vs. SH; 17%, p<0.05), gunshot injuries (MH; 5% vs. SH; 18%, p<0.05), higher mean ISS (MH; 30.2 +/- 8.4 vs. SH; 42.8 +/- 10.2, p<0.001), and increased mortality (MH; 2.6% vs. SH; 11.1%, p<0.001). AIS(abdomen) was the highest component in the SH registry (AIS(abdomen) = 4.8 +/- 0.7), whereas AIS extremities were the highest component in the MH registry (AIS(extremities) = 3.6 +/- 0.2). CONCLUSION: Significantly different demographic features, mechanisms of injury, worse outcomes and higher mortality rates in SH demonstrate and reflect the surgical challenges depending on the combat environment. Two hospitals in Turkey, one seemingly adjacent to a war zone and another with the more standard civilian experience highlight the impact of the Syrian conflict on the Turkish healthcare system.