penetrating trauma victims in three tehran hospitals, sina, shohada, fayazbakhsh: epidemiology and management errors

this is an observational case series study on penetrating trauma admissions in three teaching hospitals in tehran from 1996 to 1997. in order to describe the epidemiology and determine the ways of improving treatment of penetrating injuries, we selected 410 patients with penetrating injuries and injury severity scores (iss) of more than 7 (the maximum iss is 75) out of 3580 trauma patients, hospitalized in the three hospitals (sina, shohada, fayzbakhsh) since may 1 st 1996 during a period of approximately one year. these hospitals were among the ones with the highest load of trauma patients in tehran. the in- hospital mortality rate was 2% and the rate of permanent disability was 6%. the most frequent injuries were in the extremities; while the most fatal ones occurred in the head and neck region.the mean ± se injury severity score was 10.9±0.23 . cutting was the most prevalent mechanism of injury while gunshot was the ratest. the most fatal mechanism of injury was gunshot followed by stab can cutting injuries. industrial workers comprised the population at the highest risk for other cutting injuries, which can be avoided by utilizting better protection facilities at work.our findings show that the improvement of preventive measures in industrial occupations should be considered to be of utmost importance. it seems that faster and direct transporation of patients to appropriate and well- equipped centers, improvement of the technical skills of the emergency staff, appropriate tiage of trauma victims and decreasing the time spent in the emergency room can decrase the mortality rate substantially