The epidemiological analyses of trauma patients in Chongqing teaching hospitals following the Wenchuan earthquake.
BACKGROUND
Well-equipped comprehensive hospitals may provide better emergency and patient services for the recovery of injured patients from the earthquake zone. This study aimed to provide an overview of injuries among the patients admitted to the six teaching hospitals in Chongqing, China, after the 2008 Wenchuan earthquake.


METHODS
The medical records of 533 earthquake victims who were treated and followed-up by the six hospitals were analysed retrospectively. Patients' demographic data, diagnosis, microbiological assessment and dispositions were reviewed.


RESULTS
Of the 533 patients, 45.0% patients had an Injury Severity Score (ISS) below 8, 41.1% had an ISS between 9 and 14 and 13.9% had an ISS above 15. The patients were classified based on their fracture sites as follows: head and neck (7.9%), face (1.3%), chest (21.4%), abdomen and pelvis (15.2%), limb and pelvis (58.9%) and body surface (38.5%). Of the 533 patients, 41.6% had a single fracture site, 32.1% had two combined fracture sites and 26.3% had more than three combined fracture sites, while 32 (6.0%) patients suffered from amputation, 3.9% suffered from crush syndrome and 52.7% underwent surgical operations at the hospitals. Seventy-nine (14.8%) patients suffered from infections, including 87.3% of pre-hospital infections. The results from bacterial culture and antibiotic susceptibility assays showed that the infectious bacteria mainly involved Escherichia coli, Staphylococcus aureus, Staphylococcus haemolyticus, Baumanii, Aerobacter cloacae, Pseudomonas aeruginosa, C type chain coccus and Bacillus aerogenes capsulatus. The sensitivity of various bacterial strains to antibiotics did not exhibit obvious changes, except that the previously multi-drug-resistant hospital bacteria were sensitive to antibiotics.


CONCLUSIONS
For emergency conditions after a catastrophe, comprehensive hospitals must be prepared to meet the massive numbers of severely injured patients. Trauma patients from delayed rescue and admission should be given broad-spectrum antibiotics, such as cephalosporin and macrolide antibiotics. The selection of antibiotics in the combination therapy, as described in this study, may greatly enhance the effectiveness of early specific treatments and prevent severe trauma complications in future natural disasters.
Yang
Ce
C
State Key Laboratory of Trauma, Burns and Combined Injury, Research institute for Traffic Medicine of People's Liberation Army, Daping Hospital, Third Military Medical University, Chongqing, PR China.
Wang
Hai-yan
HY
Zhong
He-jiang
HJ
Zhou
Lin
L
Jiang
Dian-ming
DM
Du
Ding-yuan
DY
Hu
Ping
P
Jiang
Jian-xin
JX