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Inventi Impact - Emergency Medicine
(Formerly Inventi Rapid/Impact: Trauma)

Articles

  • Inventi:htr/81/14
    CLINICAL REVIEW IS ESSENTIAL TO EVALUATE 30-DAY MORTALITY AFTER TRAUMA
    Poya Ghorbani, Magnus Falken, Louis Riddez, Martin Sundelof, Anders Oldner, Lovisa Strommer

    Background: Securing high-quality mortality statistics requires systematic evaluation of all trauma deaths. We examined the proportion of trauma patients dying within 30 days from causes not related to the injury and the impact of exclusion of patients dead on arrival on 30-day trauma mortality. We also defined the demographics, injury characteristics, cause of death and time to death in patients admitted to our trauma center who died within 30 days, between 2007-2011. Methods: Demographics, injury characteristics, status alive/dead on arrival, cause of death and time to death of all patients were reviewed. Deaths were analyzed based on injury mechanism (penetrating, blunt trauma and low energy blunt trauma) and cause of death (traumatic brain injury (TBI), hemorrhage, organ dysfunction and other/unknown). Results: Of the 7422 admissions, 343 deaths were identified of which 36 (10.5%) involved causes not related to the injury. The overall age was 71 years, Injury Severity Score (ISS) 29 and time to death 24 hours (all medians). Fifty-four patients (17.6%) were dead on arrival. Exclusion of patients dead on arrival reduced the overall mortality rate (P < 0.05) and median ISS (P < 0.05) and increased median age (P < 0.01) and time to death (P < 0.001). Injury mechanism was penetrating trauma in 7.5%, blunt trauma in 56.0%, and low energy blunt trauma in 36.5%. TBI accounted for 58.6%; hemorrhage 16.3%, organ dysfunction 15.0%, and other/unknown for 10.1% of the deaths. Patients who died after low energy blunt trauma were older, had lower ISS and longer time to death compared to those who died after penetrating and blunt trauma (all P < 0.01). Conclusions: Clinical review of all trauma deaths was essential to interpret mortality. Thirty-day trauma mortality included 10.5% deaths not directly related to the injury and the exclusion of patients dead on arrival significantly affected the unadjusted mortality rate, ISS, median age and time to death.

    How to Cite this Article
    CC Compliant Citation: Ghorbani et al.: Clinical review is essential to evaluate 30-day mortality after trauma. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2014 22:18, doi:10.1186/1757-7241-22-18. © Ghorbani et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://?creativecommons.?org/?licenses/?by/?2.?0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://?creativecommons.?org/?publicdomain/?zero/?1.?0/?) applies to the data made available in this article, unless otherwise stated.
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