Inpatient hospital outcomes following injury in Suriname: lessons for prevention

Traumatic injury is an important and indiscriminant contributor to mortality. Hypothesizing that outcomes from severe injuries do not vary by demographic factors or socioeconomic status, this research analyzed the relationship between race, ethnicity, injury characteristics, and fatality following hospitalization in Suriname. Data were obtained for all hospital episodes in 2008 from the only hospital within the greater Paramaribo area that provides emergency department services. A logistic regression was used to analyze the subset of 544 non-elderly adult trauma victims to assess the contribution of patient demographics and anatomic injury severity to outcome, which was defined as mortality during acute hospitalization. The specific demographics included were patient age, gender, race, and insurance status. Injury severity was measured using the International Classification Injury Severity Score. The results indicate that age, insurance status, injury type, and injury severity were significant predictors for survival. While the uninsured experienced a higher rate of mortality, the model suggests this result is not due to physiologic reasons but behavioral and socioeconomic. The higher mortality is driven by greater injury severity, which increases not only the mortality rate but also the cost of care. Injury severity itself, independent of all other factors, is the most important contributor. The results suggest that a reduction of 10% in injury severity, around the mean, would reduce the probability of mortality by 70%. This suggests that targeting risk-taking behavior, perhaps relating to compliance with safety practices (e.g. seat belt and helmet laws), driver education, and road safety measures can play important roles in reducing mortality and morbidity from injury in Suriname.