Patterns of In-hospital Mortality and Causes of Death in Blunt Poly-trauma Patients

Abstract

This study evaluates patterns of in-hospital mortality and causes of death in blunt poly-trauma patients. Methods: Data of blunt poly-trauma patients admitted between 2011 and 2013 were retrospectively collected and analyzed. Poly-trauma was defined as an Injury Severity Score (ISS) was greater than 15. The following variables were extracted and analyzed: age, sex, ISS, Revised Trauma Score (RTS), injury mechanism, cause of death, and patterns in-hospital mortality rate. Results: Two hundred and ten patients with blunt poly-trauma were admitted. Injuries occurred predominately in the age group of 45∼64 years. Injuries occurred predominantly in males (70%). Traffic accidents (67.6%) and falls (30.5%) were the main causes of trauma. Forty-six patients (21.9%) died in the study sample. Six patients (13%) died within one hour, 23 (23.9%) between one and four hours after arrival to emergency room, six (6.5%) died during the first two weeks of hospitalization, and six (6.5%) died in the fourth week of hospitalization. The median ISS of those who died was 39.5 (20.5∼70.5) and median RTS was 4.01 (1.85∼6.15). The major cause of early death was exsanguination (39.1%), followed by central nervous system injury (34.8%). Sepsis or multi-organ failure (26.1%) were the predominant causes of late death. Conclusion:The in-hospital mortality rate is similar to other studies. However, cause of death and injury mechanisms of blunt poly-trauma death are somewhat different from other countries. Recognition of these injury and mortality patterns will help improve the trauma system.

Relationships between trauma death, disability, and geographic factors: a systematic review

“…Trauma is a global health problem [ 1 ], causing a reported 58 million global deaths every year, which represents about 10% of all deaths [ 2 ]. Since trauma was recognized as a critical cause of death and disability in patients, multiple studies of trauma-related mortality and disability have been published [ 3 ]. According to an annual report summarizing the causes of death published by Statistics Korea, 304,948 Koreans died from trauma in 2020.…”

“…The accessibility of medical services and service quality may significantly affect an individual’s health [ 13 ]. The causes of trauma-related deaths may also vary regionally due to socioeconomic and geographical factors [ 3 , 14 ]. Many advanced nations have reported such a correlation between geographical factors and incidence of trauma [ 15 , 16 ].…”

Are Preinjury Anticoagulant and Antiplatelet Medications a Pitfall in the Bleeding Tendencies of Elderly Trauma Patients in Intensive Care?

“…The elderly are more susceptible to complications and death following a trauma. One study reported that a large proportion of trauma patients (21.7%) were older than 75 years [3,4]. The elderly are susceptible to more severe injuries than younger individuals, and may have a compromised physiology [5].…”

“…A study in 2010 [8] continued to report that brain injuries were the main cause of death, and haemorrhage as the second. However, another study [4] reported that in 2014, haemorrhage was the main cause of death following trauma, implying that active treatment of haemorrhages is key in trauma patients. The elderly are more likely to be on anticoagulant or antiplatelet medications than younger individuals, due to underlying disease [9], which increases the risk of bleeding, making initial fluid therapy and intensive monitoring even more important following an accident [10][11][12][13].…”