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999			_c525 _d525
003			OSt
005			20220906184544.0
008			190211b ||||| |||| 00| 0 eng d
060			_aTHS-00063
100			_aAmatya, Ujjwal. _91657
245			_aInjury sevirity score (TRISS) in our set up.
260			_cc2001.
300			_a48p.
500			_aThesis Report.
520			_aABSTRACT: Background: As trauma is a major cause of death in younger generation, trauma audit is important to set standards and keep on improving the service and set new standards. In order to set standard we should know where we stand and realize our pitfalls in the management of a trauma care. This paper deals with an incidence of trauma, causes the magnitude of the problem, its management and the outcome. Its outcome is compared with the outcome achieved by other centers in order to find out where we stand today. Method: 54 cases of major trauma victims, which presented to Bir hospital with AIS of more than 12 were randomly selected and subjected to TRISS evaluation. Probability of survival was calculated using the TRISS method. All the patients were followed up till they were discharged or expired. The probability of survival calculated from TRISS method and actual outcome were compared and the results and the observations were statistically tabulated. Result: Of all the 54 cases that were subjected to TRISS calculation, 17 patients died and 37 patients survived. All the patients except one with probability of survival below 0.5 at the time of arrival at the hospital expired. Unlike the western world outcome, most of the patients who expired had probability of survival more than 0.5. These data shows our efficiency in dealing with major trauma victims. Overall mortality was 31.5%. Conclusion: With the help of scoring, using TRISS methodology, probability of survival of injured patient can be predicted fairly well with reasonable accuracy. Although our survival is worst than the western world's data, calculated accuracy is significant but cut off value for survival must be raised from 0.5 as in western data to 0.75 to predict the survival, which will give specify of almost 100%. We lack in efficiency in dealing with trauma victims. Pitfalls in our management start from immediate initial management at the scene of the accident, transport, emergency management and definite management. We lack in facilities and manpower. We are nowhere near in achieving best results in trauma management . we should set our standards and achieve it and set new standards for future. If we cannot achieve it, we must find our difficulties and weakness and constantly improve the service. In this way we can upgrade our efficiency in dealing with trauma victims. In order to set new standards, a scoring system must be developed for comparison with each other and to scale our improvement. The developed system must be cheap; reliable, fast and easy to reproduce with same accuracy. This paper deals with a way of developing a scoring system that is applicable in our setup, which will reliably predict and outcome in major trauma cases.
546			_aEng.
650			_aTrauma victims. _91743
650			_aEmergency management. _91744
856			_uhttp://nhrc.gov.np/contact/ _yVisit NHRC Library
942			_2NLM _cTR