Mahnaz Yadollahi - Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Amir Hossein Shams - Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Mahsa Ahadi - Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiva Aminnia - Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Strategies to prevent and provide an appropriate post-injury care system are vital save resources and reduce fatalities and disabilities. The present study aimed to evaluate risk factors for early and late mortality.Method: This cross-sectional study was conducted at a trauma referral center in southern Iran from June ۲۰۱۹ to June ۲۰۲۰. Based on the length of hospital stay, the patient’s outcomes were classified as short-term (within the first ۴۸ hours of admission) or long-term (beyond ۴۸ hours of admission) categories. Predictors of mortality evaluated included gender, age, Glasgow Coma Scale, presence of significant trauma using the Injury Severity Score, mechanism of injury, the need for intubation or chest tube placement, and hospital-acquired infection.Results: This study was performed on ۱۲۸۱ patients with a mean age of ۳۷.۹ ± ۱۹.۱ years. The median length of hospital stay was ۷.۷ days, with a mean injury severity score of ۱۶.۳ ± ۱۱.۳. The primary mechanism of injury was road-traffic accidents (۶۵.۵%), followed by falling (۱۵.۲%). During the first ۴۸ hours of hospitalization, ۲۱۷ of ۱۲۸۱ patients died or were discharged, the long-term group included ۱,۰۶۴. The risk factors were age≥۶۵ years (OR=۵.۷۱, CI:۳.۱۶-۱۰.۳), GCS ۹-۱۲ (OR=۳.۳۹, CI:۱.۵۵-۷.۴۲), GCS≤۸ (OR=۵.۸۸, CI:۳.۱۴-۱۱.۰۳) major trauma (OR=۱.۹۲, CI:۱.۰۵-۳.۵۲), and chest tube insertion (OR=۲.۴۹, CI:۱.۴-۴.۴۳) for short-term mortality and ۴۵-۶۴ age group (OR=۵.۹۵, CI:۳.۱۸-۱۱.۱۵), age≥۶۵ years (OR=۲۲.۱۲, CI:۱۱.۳۸-۴۲.۹۷), GCS ۹-۱۲ (OR=۲.۹, CI:۱.۴-۶.۰۲), GCS≤۸ (OR=۵.۵۳, CI:۳.۰۳-۱۰.۱۱), major trauma (OR=۱.۹۹, CI:۱.۱۱-۳.۵۴), chest tube insertion (OR=۲.۹۶, CI:۱.۶۸-۵.۲۳), and incidence of hospital-acquired infection (OR=۲.۴۲, CI:۱.۴۳-۴.۱) for long-term mortality.Conclusion: Despite the similarities in the predictors of short-term and long-term mortality in trauma patients, our study showed that the effect of the age in these two groups varied. To improve the prognosis of unstable trauma patients, they should be categorized based on time and age.

Hospital mortality, Accidents, triage, Length of stay, Prognosis