Assessment of traumatic deaths in a level one trauma center in Ankara, Turkey

Abstract

Trauma management shows significant progress in last decades. Determining the time and place of deaths indicate where to focus to improve our knowledge about trauma. We conducted this retrospective study from data of trauma victims who were brought to a major tertiary hospital which is a level one trauma center in Ankara, Turkey, and died even if during transport or in the hospital between 1 March 2010 and 1 March 2013. The patients' demographic characteristics, trauma mechanisms, time frames and causes of deaths determined by physicians were recorded. Traumas were grouped as "high energy trauma" (HET) and "low energy trauma" (LET). Falls from ground level were defined as LET. 209 traumatic deaths due to trauma or trauma-related conditions were found in the study period. 161 of 209 (78 %) patients suffered from HET. Motor vehicle collisions (MVC) (56 %) were the most common mechanism of trauma followed by burns (16 %), falls (11 %), gunshots (9 %) and stabs (6 %) in this group and traumatic brain injuries (TBI) (41 %) were the most common cause of death followed by circulatory collapse (22 %) and multi-organ failure (20 %). 36 % of deaths occurred before arrival at hospital, 25 % in the first 24 h of admission, 18 % between 2nd and 7th day and 21 % after first week. Trimodal distribution of traumatic deaths was not valid for all types of injuries and the most important factor to decrease traumatic deaths is still prevention. Also we have to keep on searching to improve our knowledge about trauma management.

Analysis of the patients admitted to emergency department due to urogenital trauma and investigation of factors that affect mortality

“…Güloğlu et al reported that the most common cause of urogenital injury is traffic accidents [7]. Arslan et al in their study stated that the most frequently injuries are seen due to traffic accidents [12]. Our results are consistent with the literature.…”

Trauma Survey of 476 Doctors: Now We know What We Do not know

“…4 In the last decade, Turkey has been focusing on improving its emergency medical care system that also provides trauma care. 5 Despite studies that have assessed the causes of traumatic deaths in Turkey and the need to improve overall trauma care, 6 the required components of level I trauma centers, such as providing leadership in trauma prevention and public education, providing training of the trauma team members, building a systematic teaching and research effort system to direct new innovations in trauma care, developing new strategies based on a trauma database, and others 7 are still lacking. Trauma mortality rates in the Turkish trauma system are higher when compared with the mortality rates reported by trauma centers in the United States.…”

Acil Serviste Travmatik Ölümlerin Retrospektif Değerlendirilmesi

“…Trajano ve arkadaşları en sık travmatik ölüm sebebinin araç dışı trafik kazası olduğunu bildirmişlerdir 11. Arslan, Evans ve arkadaşları travmatik ölümlerin sırasıyla %44 ve %72 oranında motorlu taşıt kazası sonucu olduğunu tespit etmişlerdir 9,13. Gunst ve arkadaşları ise farklı olarak travmaya bağlı ölümlerin en sık sebebinin ateşli silah yaralanması olduğunu bildirmişlerdir 12.…”

“…Çalışmamızda başvurusunda arrest olan hastaların 71'inde ve arrest olmayanların 43'ünde baş-boyun yaralanması mevcuttu. Arslan ve arkadaşları travmaya bağlı ölümlerde en sık nedenin travmaya bağlı beyin yaralanması olduğunu bildirmişlerdir 9. Trajona, Gunst, Hamzeh ve arkadaşları travmaya bağlı ölümlerde en sık nedenin kafa travması olduğunu bildirmişlerdir 11,12,14.…”