Magnitude of Trauma Magnitude of Trauma in Saudi Arabiain Saudi Arabia

Second Saudi Surgical Society Annual Meeting

May 21-22, 2006

Dr. Saud Al-Turki

King Abdulaziz Medical City National Guard Health Affairs

WHO 2005 Global MortalityWHO 2005 Global Mortality

IHD IHD (1)(1) 12.612.6

Cerebrovascular Disease Cerebrovascular Disease (2)(2) 9.7 9.7

Respiratory Infection Respiratory Infection (3)(3) 6.96.9

HIV HIV (4)(4) 4.84.8

RTA RTA (10)(10) 2.12.1

Trauma is the leading cause of death (1 to 44) of ageTrauma is the leading cause of death (1 to 44) of age

In Saudi Arabia Ministry of Health report 1998 -----> 81% In Saudi Arabia Ministry of Health report 1998 -----> 81%

Hospital Mortality -----> RTAHospital Mortality -----> RTA

KFNGH 2005 T.R. report - Hospital Mortality 8% -----> RTAKFNGH 2005 T.R. report - Hospital Mortality 8% -----> RTA

KingdKingdomom ofof Saudi Saudi ArabiaArabia

PopulationPopulation 19.4 Million19.4 Million

66%66% SaudisSaudis

66%66% < 15 yrs of age< 15 yrs of age

Annual Trauma Annual Trauma Admission Admission

1,2001,200

(Trauma Registry KFNGH 2004/2005)

53%53% RTARTA

20% 20% FallsFalls

5000 Trauma 5000 Trauma pts/yrpts/yr

0 5 10 15 20 25 30 35 40 45 50

Motorvehicle Accidents

Pedestrian

Motorcycle Accidents

Falls

Scald Burn

Burn Flame

Homicide or injury inflected by other

Suicide or self inflected injury

Drowning, Submersion and Foreign body

Mechanical Equipment

Poisoning

Mechanism of Injury for 2004 Mechanism of Injury for 2004 admitted patientsadmitted patients

Percentage

0.16%

0.4%

3%

0.4%

6.8%

2.9%

3.9%

20%

1.4%

10%

43%

Trauma Patient GenderTrauma Patient Gender

(Traffic Police Annual Report 2005)(Traffic Police Annual Report 2005)(Trauma Registry KFNGH 2004, 2005)

Male Female

0 5 10 15 20 25

Burn

Motorcycle Accident

Drowning

Fall

Homocide Injury

RTA

Pedestrian

Causes of Injury Average (ISS)Causes of Injury Average (ISS)

Percentage

16.4 %

14.7 %

7.5 %

5.2 %

8.7 %

8.3 %

21.9 %

Trauma Patients by Age for 2005Trauma Patients by Age for 2005

Percentage

0 10 20 30 40

< 1

1 to 5

6 to 12

13 to 25

26 to 35

36 to 55

56 to 65

> 65

2.04 %

13.96 %

12.77 %

36.6 %

13 %

13 %

3.3 %

5 %

FallsFalls

•Mainly during the summer holiday•Causes significant mortality and morbidity

• 52 % Falls from windows 1-3 meters• 12 % Falls from second floor balcony• 70 % Children• 67 % Males

FireFire

Annual CasesAnnual Cases InjuryInjury MortalityMortality

20012001 24,08624,086 1,6221,622 6.7%6.7% 272272 1.1%1.1%

20022002 25,23925,239 1,4791,479 5.9%5.9% 244244 0.9%0.9%

20032003 26,61926,619 1,0191,019 3.8%3.8% 128128 0.4%0.4%

20042004 30,26530,265 1,0761,076 3.5%3.5% 137137 0.45%0.45%

20052005 29,70129,701 941941 3.1%3.1% 171171 0.57%0.57%

Average Mortality per year (1.45)

(Annual Civil Service Statistics)

DrowningDrowningAverage Mortality 69%Average Mortality 69%

Annual CasesAnnual Cases MortalityMortality

20012001 195195 162 83%162 83%

20022002 185185 123 66%123 66%

20032003 311311 166 53%166 53%

20042004 203203 164 80%164 80%

20052005 206206 138 66%138 66%

(Annual Civil Service Statistics)

Total Number of Car Accidents in KSA Total Number of Car Accidents in KSA

271,267 271,267 (2005) (2005)

33,943 33,943 injured injured

5,012 -----5,012 ----- 10,441 died 10,441 died(Annual Traffic Police Statistics)

RTARTA

Death Rates from Injury per 100,000 PopulationDeath Rates from Injury per 100,000 Population

WHO 1998

Japan

Germany

Canada

Albania

Spain

Argentina

New Zealand

Chile

United States

Mauritius

Austria

Colombia

Norway

Greece

Mexico

Italy

Venezuela

Portugal

Belgium

Bulgaria

Croatia

Scotland

France

Finland

Poland

Cuba

Slovenia

Romania

Czech Rep.

Denmark

Saudi Arabia

Hungary

Russia

42734

29000 28739 29372 30122

3481133943

9975 9206 8145 8668 883510710 10441

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

1999 2000 2001 2002 2003 2004 2005

Injuries

Mortality

Annual RTA Mortality and InjuriesAnnual RTA Mortality and Injuries

(Annual Civil Service Statistics)

83672

44442 45316 45721 47184

89378

6534372436

84113 83263

6908974481

616555177566417

0

10000

20000

30000

40000

50000

60000

70000

80000

90000

100000

2001 2002 2003 2004 2005

Riyadh

Makkah

Annual Cities Injuries - SimpleAnnual Cities Injuries - Simple

(Annual Traffic Police Statistics)

Eastern Province

1835

2082202522442715

1072410836

899281087713

27262016 2210 1954

2642

0500

100015002000250030003500400045005000550060006500700075008000850090009500

100001050011000

2001 2002 2003 2004 2005

Riyadh

Makkah

Annual Cities Injuries – SevereAnnual Cities Injuries – Severe

(Annual Traffic Police Statistics)

Eastern Province

Mechanism of D.O.A. (49 pts)Mechanism of D.O.A. (49 pts)

(KAMC Trauma Registry 2004-2005)

0

10

20

30

40

50

60

70

MVA Pedestrian Drowning Homocide

63 %

18 %

6 %4 %

Percentage

%

Mechanism of death in Hospital (70 pts)Mechanism of death in Hospital (70 pts)

(KAMC Trauma Registry 2004-2005)

05

101520253035404550

Percentage

%

21.5 %

10 % 10 %

43 %

12 %

Causes of RTACauses of RTA

(Annual Civil Service Statistics)

Speeding 2001 40 %

2005 8.96 %

Driver

Road

Car

Tire Failure

13%

Crossing Red Light

2001 8 %

2005 3.29 %

Do We have a Do We have a Problem with Problem with

Trauma in Trauma in KSA ?KSA ?

KSAKSA 32 accidents 32 accidents 1 death1 deathUSAUSA 283 accidents283 accidents 1 death1 death

High Speed ! Seat Belt use !High Speed ! Seat Belt use !

KSAKSA 8 accidents8 accidents 2 injuries2 injuriesUSAUSA 8 accidents8 accidents 1 injury1 injury

80% of trauma victims < 30 years of age 80% of trauma victims < 30 years of age

1/51/5thth of hospital beds occupied by RTA of hospital beds occupied by RTA victimsvictims

Annual Government loss from car Annual Government loss from car accidents > 21 Billion Riyalsaccidents > 21 Billion Riyals

We have a We have a ProblemProblem

Types of AccidentsTypes of Accidents

Two CarsTwo Cars 80 %80 %

Accident with fixed objectAccident with fixed object 6 %6 %

PedestrianPedestrian 3 %3 %

Car Turn OverCar Turn Over 3 %3 %

Animal Collision AccidentsAnimal Collision Accidents 0.1 %0.1 %

(Annual Police Statistics Office)

RTA Interesting FactsRTA Interesting Facts

Time & Location

Days of the week

Month

62.5% of accidents during 62.5% of accidents during the daythe day82.3% inside cities82.3% inside cities

Wednesday 16.5%Wednesday 16.5%Saturday 15.5%Saturday 15.5%Friday 11%Friday 11%

Ramadan & Hajj SeasonRamadan & Hajj Season

RecommendationsRecommendations

Traffic law enforcementTraffic law enforcement

Road safety regulationsRoad safety regulations

Seat belt for driver, Seat belt for driver, passengers & childrenpassengers & children

Vehicle inspection officersVehicle inspection officers

Pedestrian safety regulationsPedestrian safety regulations

RecommendationsRecommendations

Strict swimming pools safety rulesStrict swimming pools safety rules

Use of window type balcony with fences Use of window type balcony with fences and stairs protection to avoid children fall and stairs protection to avoid children fall accidentaccident

National accurate trauma statistics National accurate trauma statistics (National Trauma Registry)(National Trauma Registry)