title: Direct (presenting primarily to trauma center) versus indirect (referred or transferred) admission of patients to the Trauma Centre of King George Medical University: One-year prospective pilot study.
abstract: BACKGROUND
  India does not have a trauma registry. There is lack of base line demographic data of trauma victims that present directly to the trauma center and those that are transferred to the trauma center.
  
  
  OBJECTIVE
  To compare the clinical and demographic profile of directly admitted (presenting primarily to the trauma center) and referred (transferred to trauma center) patients at the trauma centre of King George Medical University.
  
  
  METHODS
  The demographic and clinical profiles of patients admitted on thirty-three consecutive Mondays were collected and compared. In addition, the demographic data of patients admitted on Mondays and eight randomly selected Wednesdays and Saturdays were analyzed to ascertain the representativeness of the studied sample.
  
  
  RESULTS
  Of the 572 patients in the study, 327 were referred and 245 were directly admitted. There was 27% mortality in the referred group and 22% mortality in the directly admitted group, the difference been statistically insignificant (P value 0.20). Patients referred from peripheral hospitals were more severely injured with a lower GCS and a higher TRISS, and had a higher proportion of multi system major trauma and severe head injury.
  
  
  CONCLUSIONS
  Referred admitted (transferred) patients at the KGMU trauma center are more seriously injured than the patients presenting directly. Yet there is no statistically significant difference in the overall mortality. A future study focusing on certain sub-categories of patients such as those demonstrating subdural hematoma, GCS less than 9 or ISS more than 15 may yield interesting data.
authors.affiliation: Department of Orthopaedics, King George Medical Universtity, Lucknow, Uttar Pradesh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Verma
authors.affiliation: Department of Orthopaedics, King George Medical Universtity, Lucknow, Uttar Pradesh, India.
authors.forename: Girish K
authors.initials: GK
authors.lastname: Singh
authors.affiliation: Department of Orthopaedics, King George Medical Universtity, Lucknow, Uttar Pradesh, India.
authors.forename: Santosh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Orthopaedics, King George Medical Universtity, Lucknow, Uttar Pradesh, India.
authors.forename: Vineet
authors.initials: V
authors.lastname: Sharma
authors.affiliation: Department of Trauma and Emergency, AIIMS, Patna, Bihar, India.
authors.forename: Vijaysheel
authors.initials: V
authors.lastname: Gautam
authors.affiliation: Department of General Surgery, King George Medical Universtity, Lucknow, Uttar Pradesh, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Kumar
keywords: Admission; direct; transferred; trauma centre