Polytrauma in Emergency Settings: A Multidisciplinary Approach to Skeletal and Neurological Stabilization

Abstract

Introduction: Polytrauma is a leading contributor to morbidity and mortality globally, particularly in low- and middle-income countries. Objective: This study evaluated the epidemiological trends, injury profiles, and outcomes of polytrauma patients in an emergency setting in Bangladesh, with a focus on skeletal and neurological stabilization and the role of multidisciplinary care. Methods: A 12-month prospective observational study was conducted at the National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka, on 120 adult polytrauma patients (_18 years) presenting within 6 hours of injury. Data collected included demographics, injury types, Glasgow Coma Scale (GCS), interventions, ICU admissions, and functional outcomes via Glasgow Outcome Scale (GOS). Cox proportional hazards modeling was applied to identify predictors of recovery. Results: The mean age was 38.2±14.6 years; 65% were male. Road traffic accidents accounted for 60% of injuries. Long bone fractures (51.7%) and TBIs (46.7%) were most frequent. External fixation was the most common intervention (35%). Multidisciplinary management was provided in 63.3% of cases and significantly improved outcomes (p<0.001). Mortality was 11.7%; 48.3% achieved good recovery (GOS 5). Cox analysis showed better outcomes with multidisciplinary care (HR=1.68, p=0.009), higher GCS, and younger age. Conclusion: Multidisciplinary trauma care is vital for improving functional outcomes in polytrauma. Early stabilization and collaborative interventions should be prioritized in resource-limited emergency settings.

J Rang Med Col. 2025 Sep;10(2): 66-71