Injury-related deaths in the Ontario provincial trauma system: a retrospective population-based cohort analysis

Abstract

I n most countries, including Canada, injury remains the leading cause of death in the first 4 decades of life and accounts for more productive years of life lost than any other disease process. 1,2 People with major trauma experience a 20% mortality rate, and many survivors are left with permanent disability, 3 mental health difficulties 4-6 and a heightened risk of suicide. 4 In the last several decades, many regions 7 including Ontario 8 have developed "trauma systems" to coordinate care for severely injured patients. 7-9 "Trauma systems" are approached from a public health perspective and aim to provide the full spectrum of trauma care, including rapid emergency medical services response, access to specialist trauma care and rehabilitation programs. 10 Given that the key function of a trauma system is to reduce injury mortality, it is important to understand the epidemiology of deaths that occur in the system. To date, no studies have described the epidemiology of fatal injury in a Canadian provincial trauma system. Previous studies from the United States have generally been small or regional, with limited generalizability to the Canadian context because of differing patterns of injury (e.g., higher rates of penetrating injuries in the US), variations in health care system design and socioeconomic factors. 11-14 Our objective was to describe patterns of fatal injury in Ontario, with a focus on location of death and receipt of surgical intervention before death. We hypothesized that injury deaths would frequently occur outside of trauma centres and in the absence of potentially life-saving surgical intervention. Methods Study design We conducted a retrospective, population-based cohort study of fatal injuries from blunt or penetrating trauma in Ontario, Canada, from 2000 to 2016.

The pattern of Deaths in the Accident and Emergency Units of Ekiti State University Teaching Hospital

“…Both result from road traffic crashes. This corroborates the findings of previous studies that reported road traffic crashes as the most common cause of trauma-related deaths recorded in the AEU [3,4,17,27,[30][31][32][33]. Overall, there were more traumatic surgical deaths than non-traumatic surgical deaths.…”

Leading patient-centric crisis preparedness in healthcare: Lessons from Ukraine

“…For example, it has been reported in 2021 that most injury deaths in Ontario prevailed in locations out-ofhospital settings or were managed at non-trauma centres, leaving access to specialized injury care despite public health's efforts in developing effective "trauma systems." 46 Utilizing publicly available findings, dedicating resources to integrate health data 47 into hospital board decisional process could generate powerful insights to generate evidence-based managerial projections of clinical resources allocations. This is of significant importance considering emergency department visits have been outpacing population growth for years now.…”

“…Considering that exposure to war-factors would vary from region to region, and thereby generate geolocated differentials in clinical epidemiology, multinomial logistic model of diagnosis status were used to project statistically significant estimates of clinical morbidity variability across the Ukrainian landscape and to map out team response patterns and routes in accordance to the statistical projections. For example, it has been reported in 2021 that most injury deaths in Ontario prevailed in locations out-of-hospital settings or were managed at non-trauma centres, leaving access to specialized injury care despite public health’s efforts in developing effective “trauma systems.” 46 Utilizing publicly available findings, dedicating resources to integrate health data 47 into hospital board decisional process could generate powerful insights to generate evidence-based managerial projections of clinical resources allocations. This is of significant importance considering emergency department visits have been outpacing population growth for years now.…”

Guided blood transfusion of trauma patients with rotational thromboelastometry: a single-center cohort study

“…Trauma remains one of the leading causes of death in adults [ 1 , 2 ]. Nearly all deaths after trauma occur within the first 24 h, and uncontrolled bleeding is the most significant cause of preventable death in severe traumatic injuries [ 3 , 4 ].…”