PURPOSEThe objective of this study was to establish the relationship between the timing of admission to a hospital and the severity of injuries following an earthquake.

METHODSIt was a retrospective chart review of injured patients admitted to a tertiary care teaching hospital following the 2005 Pakistan earthquake. Age, gender, injury severity score, type of injuries, complications, operations, hospital stay and mortality were studied and compared at different time intervals using SPSS.

RESULTSMost injuries were musculoskeletal [145 (59%)] vs. all other injuries, including minor lacerations [103 (41%)], but the percentage of non-musculoskeletal injuries was higher within 24 h (67% vs. 53% respectively, p = 0.4). Injury severity score (25 ± 10 vs. 16 ± 9, p=0.01), multiple injuries [73% vs. 45%, p=0.05] and crush syndrome [20% vs. 03%, p = 0.02] were significantly higher in patients admitted within 24 h. More patients with head and neck injuries were admitted within 24 h (27% vs. 18%, p = 0.4). Patients admitted within 24 h had higher complication rates (67% vs. 32%, P = 0.01) as well as mean operative procedures (2.8 ± 1.9 vs. 1.9 ± 1.9, p= 0.08).

CONCLUSIONOur study showed that patients admitted to a hospital within 24 h following an earthquake had more severe injuries and higher complication rate than those admitted after 24 h.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Earthquakes ; Female ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Pakistan ; Patient Admission ; Retrospective Studies ; Time Factors ; Young Adult

PURPOSE: This research was conducted to compare the management and the outcome of patients with colovesical fistulae of different aetiologies. METHODS: Retrospective data were collected from 2002 to 2012 and analyzed with SPSS ver. 17. Age, gender, aetiology, management, hospital stay, postoperative complications, and mortality were studied and compared among colovesical fistulae of different aetiologies. RESULTS: A total of 55 patients, 46 males (84%) and 9 females (16%), with a median age of 65 years (interquartile range [IQR], 48-75 years) were studied. Diverticular disease was the most common benign cause and recto-sigmoid cancer the most common malignancy. Anterior resection and bladder repair were the most frequent operations in benign cases, as was total pelvic exenteration in the malignant group. Multiple intestinal loop involvement and subsequent resection were significantly higher in those with Crohn disease than it was in patients of colovesical fistula due to all other causes collectively (60% vs. 6%, P = 0.006). Patients with malignancy had a higher postoperative complication rate than patients who did not (12 [80%] vs. 7 [32%], P = 0.0005). Pelvic collection (11, 22%) was the most frequent early complication (predominantly in the malignant group) whereas incisional hernia (8, 22%) was the most common late complication, with a predominance in the benign group. The median hospital stay was significantly prolonged in the malignant group (32 days; IQR, 17-70 days vs. 16 days; IQR, 11-25 days; P < 0.001). CONCLUSION: Despite their having similar clinical presentation, colovesical fistulae of various aetiologies differ significantly in management and outcome.
Adenocarcinoma ; Crohn Disease ; Diverticulitis ; Female ; Fistula ; Hernia ; Humans ; Intestinal Fistula* ; Length of Stay ; Male ; Mortality ; Pelvic Exenteration ; Postoperative Complications ; Retrospective Studies ; Urinary Bladder