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CHAPTER 1: DEMOGRAPHICS
There were a total of 166,768 trauma patients admitted to the Emergency Department from eight participating centres in 2009. Major
trauma patients constituted 1.2 2061166,768 of all trauma admissions. Centre E reported the highest number of major trauma cases; making up
one third of total cases 30.9.
Males were about 6.5 times more likely than the females to sustain major trauma. male 86.6 versus female 13.4. The younger age group
15-34 years: 56.6 was at the highest risk of major trauma. From the 2061 cases of major trauma, 52.9 involved Malays and 12.9 involved
foreigners.
Most of the major trauma patients attended the emergency department ED between 1801-2400 hours 31.3. There were similar
rates of admission on all days except for Sundays, which was slightly busier.
More than half 51.8 of the cases were referredtransferred from other medical facilities with Centre F receiving the highest number of
referred cases 72.1. By contract, all cases from Centre A were direct admissions. Most of the referred cases were from hospitals with specialist
46.5 and without specialist 45.4, while only a handful of the cases were referred from private clinics 0.9.
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CHAPTER 2: INJURY DETAILS
The majority of the injuries were from blunt trauma 96.3. A high percentage of the injuries were unintentional 91.2 with most of the
cases due to road traffic accidents 76.8. Motorcyclists 66.0 were at the highest risk of road traffic accidents. Injuries from home accounted for
6.8 of total cases while 5.0 of the injuries occured at industrialconstruction areas.
Emergency physician and surgical field specialists reviewed 19.9 and 11.2 of the cases respectively at the Emergency Department. About
25.9 of the cases were sent directly to the general ward, another 23.0 of the cases were sent directly to the operating theatre OT from ED and
21.0 of the cases were admitted to ICU from ED.
During hospital admission, 56.8 of the patients received ICU care. Centre E 68.0 reported the highest number of patients admitted to ICU
while Centre H only sent 4 16.7 major trauma patients to ICU in 2009.
About 61.6 of the major trauma cases had systolic blood pressure higher than 120mmHg on admission to ED and 6.1 of the cases had
systolic blood pressure of less than 90mmHg. About half 49.8 of the major trauma cases had a Glasgow Coma Scale GCS score of 3-8. More
than half of the major trauma cases had an Abbreviated Injury Score AIS of
≥ . O e i e ery fi e ajor trau a patie ts had a low Revised Trauma Score RTS of less than 5.0. Majority of the cases had an Injury Severity
Score ISS of between 16 and 25 64.8 and about 1.6 had an ISS 40. Most of the major trauma patients had injuries to the head and neck
85.4 followed by extremitiespelvic girdle 34.3.
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CHAPTER 3: OPERATIVE MANAGEMENT
In 2009, endotracheal intubation was performed on 64.8 of patients. CT Scan was done on 71 of patients. Majority of the CTs
performed on major trauma patients was for CT Brain 92.5, followed by cervical spine CTs 42.5. UltrasoundFAST was carried out in 29.5 of the
cases. Chest tube was inserted in 7.1 of major trauma patients in the emergency department.
Half 51.33 of the major trauma patients underwent surgery; the common reason was for intra-cranial injuries 63.6. Surgery for intra-
abdominal injuries was the second most common 16.92, followed by pelvic fixation 1.61.
CHAPTER 4: OUTCOME
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