Epidemiology of in-hospital trauma deaths in a Brazilian university hospital

Trajano, Adriano D; Pereira, Bruno M.; Fraga, Gustavo Pereira

doi:10.1186/1471-227x-14-22

Cited by 29 publications

(26 citation statements)

References 28 publications

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“…A study from Brazil reported that the proportion of deaths from motorcycle accidents increased by 820% between 1996 and 2007 [5]. Another study also showed that there was a significant increase in the number of deaths of motorcycle riders over time, increasing from 7.3% in 1995 to 31.5% in 2010 [6].…”

Section: Introductionmentioning

confidence: 88%

Deaths from Motorcycle Accidents: An Autopsy Study from Turkey

Ünal¹,

Ünal²,

Koral³

et al. 2018

AJFSFM

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Motorcyclists and pillion passengers in road traffic accidents have an increased risk of morbidity and mortality be- The majority of the cases were young males. Fifty (89.3%) cases were riders and six (10.7%) were pillion passengers. The vast majority (78.6%) of the cases died at the scene or on the same day in hospital. Most of the cases had multiple traumas, and the most common trauma was head trauma (n = 45). The most common injury was intracranial hemorrhage (n = 40). Fifteen (26.8%) cases tested positive for drug and/or alcohol intake.These autopsy findings can be helpful for medicolegal examinations to diagnose possible injuries and also for the automotive industry to improve better protective safety devices for motorcycle riders. ResultsDuring the 9-month period between December 2013and August 2014, a total of 56 autopsies were performed.There were 54 males (96.4%) and 2 females (3.6%). Both the female cases were pillion passengers. In total, 6 cases were pillion passengers and 50 were riders. Three cases Excluding 17 cases, for which the accident type was not recorded, the most common cause of accidents was a collision with a different vehicle (n = 23). Another 16 cases were accidents caused by the motorcycle rider, such as hitting a parked car, hitting a tree, and rollover.Regarding the number of deaths, 27 (48.2%) died at the

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Section: Introductionmentioning

confidence: 88%

Deaths from Motorcycle Accidents: An Autopsy Study from Turkey

Ünal¹,

Ünal²,

Koral³

et al. 2018

AJFSFM

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“…About 60% of deaths occurred within less than 24 h. TBI was the cause of death in 56.3%, hemorrhage in 18.1% and multiple organ failure in 17.1% of cases. Mean ISS for patients with signs of life was 26.4 ± 9.0; mean RTS was 5.24 ± 2.05, and only 25.8% had a probability of survival less than 0.5 [22] . Leow et al analyzed the effect of race and ethnicity on trauma mortality in patients with an ISS of 9 in a study coming from a 1 300-bed trauma center, from Singapore [23] .…”

Section: Discussionmentioning

confidence: 98%

“…During the study period a reduction for TBI and an increase for multiple organ failure were observed [21] . Trajano et al evaluated the epidemiology of trauma deaths in a Brazilian university hospital [22] . Out of 467 cases, 30.4% were classified as death on arrival.…”

Section: Discussionmentioning

confidence: 99%

Mortality after acute trauma: Progressive decreasing rather than a trimodal distribution

Negoi

Păun

Hostiuc

et al. 2015

Journal of Acute Disease

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Objective: To characterize the pattern of mortality for major trauma patients. Methods: Retrospective study of major trauma patients admitted in a Level I trauma center, during the latest 5 years was conducted. Selection criteria included (1) injury severity score (ISS) > 16 and (2) in-hospital death. Results: There were 47 patients, with a mean age of 37.2 ± 19.9 years. The mean ISS was 37.6 ± 12.7 and the mean revised trauma score was 4.5 ± 2.2. Computed tomography scan on admission was done in 18 (38%) patients, 20% being hemodynamically unstable (P = 0.001). The diagnostic peritoneal lavage was performed in 10 (22%) cases, 23.3% being hemodynamically unstable (P > 0.05). The mean number of intraabdominal injuries was 3. The need for transfusion was 8.2 ± 6.7 units. The mean time to death was 4.9 days. Early death was secondary to hemorrhagic shock (HS) (ISS = 35.2 ± 15.9, P > 0.05, revised trauma score = 3.74 ± 2.70, P = 0.008) and multiple organ failure (ISS = 36.6 ± 14.1, P > 0.05, revised trauma score = 5.94 ± 1.34, P = 0.008) was the cause for later mortality. Combined liver and splenic injuries were found in 13 cases, with secondary death through HS in 5 and multiple system organ failure (MSOF) in 8 cases. Combined liver, splenic and kidney injuries were found in 5 cases (cause of death: HS 2 cases, MSOF 3 cases). A total of 14 patients had associated head, thorax, abdomen and extremity trauma (cause of death: cerebral trauma 6 cases, MSOF 5 cases, HS 2 cases); 5 patients had thorax and abdomen trauma (cause of death: HS 5 cases); 8 patients had thorax, abdomen and extremity trauma (cause of death: MSOF 5 cases, HS 3 cases); 3 patients had abdomen and extremity trauma (HS 2 cases). We did not find a trimodal time distribution for mortality. Conclusions: The trimodal time distribution of mortality remains a milestone in trauma education and research. Nevertheless, it must be questioned in the modern and very efficient trauma systems, but still very actual for developing trauma care systems. In conclusion, the pattern of mortality due to major trauma seems decreasing continuously with time rather than presenting high peaks of frequency at some moments.

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“…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. Evans ve arkadaşları yüksek enerjili travmaya bağlı ölümlerde en sık nedenlerin %33 oranında santral sinir sistemi ve %33 oranında hemorajiye bağlı olduğunu bildirmişlerdir 13.…”

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Acil Serviste Travmatik Ölümlerin Retrospektif Değerlendirilmesi

Avcı¹,

Arslan²,

Büyükcam³

2017

Sakarya Medical Journal

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ÖzetAmaç Çalışmanın amacı acil serviste ilk 24 saatte meydana gelen travmatik ölümlerin özelliklerini retrospektif olarak değerlendirmektir. Gereç ve Yöntemler: Bu çalışma, retrospektif olarak 2009-2014 yılları arasında Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Acil Servisine travma nedeniyle başvuran, ilk 24 saat içerisinde travmaya bağlı bir nedenle ölen 214 hasta ile yapıldı. Hastaların yaş, cinsiyet, başvuru saati, başvuruda arrest olup-olmadığı ve anatomik yaralanma bölgeleri kaydedildi. Bulgular: Hastaların başvuru sırasında ortalama Glasgow Koma Skoru 5.11±4.10 ve Revize Travma Skoru 5.874±1.849 idi. Hastaların ortalama yaşı 48.9±20.1; %76'sı (n=163) erkek ve %24'ü (n=51) kadın idi. 100 hasta acil servise başvuru sırasında arrestti. %43 (92) hastanın 0-1 saat içerisinde, %17.3 (37) hastanın 1-3 saat içerisinde, %9.3 (20) hastanın 3-6 saat içerisinde, %4.2 (9) hastanın 6-12 saat içerisinde ve %1.4 (3) hastanın 12-24 saat içerisinde öldüğü tespit edildi. Acil servise başvurusunda arrest olan hastaların 71'inde baş-boyun, 52'sinde toraks, 8'inde abdomen, 14' ünde pelvis, 58'sinde extremite yaralanması tespit edildi. Sonuç: Sonuç olarak travmatik ölümlerin en sık erkeklerde, künt travma sonucunda ve santral sinir sistemi yaralanmasıyla oluştuğu görüldü. ( Sakarya Tıp Dergisi 2017, 7(1):15-19 ) Abstract Objective: The aim of the study is to determine characteristics of traumatic deaths occuring retrospectively in the fi rst 24 hours in the emergency deparment Material and Methods: This study was retrospectively done with 214 patients who presented to Emergency Department of Dışkapı Yıldırım Beyazıt Research and Training Hospital with a trauma reason and died from a trauma in the fi rst 24 hours between the years 2009 and 2014. The age and gender of the patients, day and time of their admission, their injury regions and their being arest or not during the admission were registered Results: The mean Glasgow Coma Score of patients was 5.11±4.101 and Revised Trauma Score was 5.874±1.849 on admission. The mean age of patients was 48.9±20,1;76.2%(163) of patients were male and 23.8%(51) of patients were female. 100 patients were arest on admission. Death hours of the patients were determined as the following; 43%(92) of them between 0-1 hour, 17.3% (37) of them 1-3 hour, 9.3%(20) of them between 3-6 hour, 4.2%(9) of them between 9-12 hour and 1.4%(3) of them between 12-24 hours. On arest patients admitted to emergency department these injuries were seen; 71 head-neck injury, 52 thorax injury, 8 abdomen injury, 14 pelvis injury and 58 extremite injuryConclusion: Consequently, it was seen that traumatic deaths were the most frequent among the males and were resulted from blunt trauma and central system injury. ( Sakarya Med J 2017, 7(1):15-19 ).

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Epidemiology of in-hospital trauma deaths in a Brazilian university hospital

Cited by 29 publications

References 28 publications

Deaths from Motorcycle Accidents: An Autopsy Study from Turkey

Deaths from Motorcycle Accidents: An Autopsy Study from Turkey

Mortality after acute trauma: Progressive decreasing rather than a trimodal distribution

Acil Serviste Travmatik Ölümlerin Retrospektif Değerlendirilmesi

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