The preventability of trauma-related death: A two-year cohort study in a trauma center in middle Taiwan

Wu, Chao-Ying; Chou, Chun-Chih; Hsu, Hao-Chun; Huei‐Ming, Matthew; Ho, Yi‐Ching; Lin, Chen‐Chiang; Chen, Yi-Jung; Chiang, Wen-Chu

doi:10.1016/j.injury.2022.06.038

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Most of the DP occurred in the ED and ward, while the PP occurred mainly in the OT and the ICU. The rate of 10.9% is lower than the 58% reported from India and the 50% reported from Ghana 14,15 but is comparable with the 4%–20% reported from Germany, the USA and Taiwan 13,16,17 …”

Section: Discussionmentioning

confidence: 45%

“…The rate of 10.9% is lower than the 58% reported from India and the 50% reported from Ghana 14,15 but is comparable with the 4%-20% reported from Germany, the USA and Taiwan. 13,16,17 Preventable trauma death is difficult to predict, and there could be wide variations between estimates and actual rates. 8 Furthermore, preventability may depend on locally available resources and expertize.…”

Section: Discussionmentioning

confidence: 99%

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Preventable deaths in hospitalized trauma patients

Alao,

Cevik,

Al Shamsi

et al. 2024

World j. surg.

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AimTo study the preventable trauma deaths of hospitalized patients in the United Arab Emirates and to identify opportunities for improvement.MethodsWe analyzed the Abu Dhabi Emirate Trauma Registry data of admitted patients who died in the emergency department or in hospital from 2014 to 2019. A panel of experts categorize the deaths into not preventable (NP), potentially preventable (PP), and definitely preventable (DP).ResultsA total of 405 deaths were included, and 82.7% were males. The majority (89.1%) were NP, occurring mainly in the emergency department (40.4%) and the intensive care unit (49.9%). The combined potentially preventable and preventable death rate was 10.9%. The median (Interquartile range) age of the DP was 57.5 (37–76) years, compared with 32 (24–42) and 34 (25–55) years for NP and PP, respectively (p = 0.008). Most of the PP deaths occurred in the intensive care unit (55.6%), while the DP occurred mainly in the ward (50%). Falls accounted for 25% of PP and DP. Deficiencies in airway care, hemorrhage control, and fluid management were identified in 25%, 43.2% and 29.5% of the DP/PP deaths, respectively. Seventy‐two percent of the Airway deficiencies occurred in the prehospital, while 34.1% of hemorrhage control deficiencies were in the emergency department. Fluid management deficiencies occurred in the emergency department and the operation theater.ConclusionsDP and PP deaths comprised 10.9% of the deaths. Most of the DP occurred in the emergency department and ward. Prehospital Airway and in‐hospital hemorrhage and excessive fluid were the main areas for opportunities for improvement.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Preventable deaths in hospitalized trauma patients

Alao,

Cevik,

Al Shamsi

et al. 2024

World j. surg.

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Preventability of injury‐related morbidity & mortality at four hospitals in Cameroon: A systematic approach to trauma quality improvement

Zheng,

Mbuh,

Oke

et al. 2024

World j. surg.

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BackgroundAdverse events reviews are a fundamental component of trauma quality improvement (QI) that facilitate the correction of systemic issues in care. Although injury‐related mortality in Cameroon is substantial, to our knowledge, opportunities for QI have not been formally assessed. Thus, a formal review of adverse events in Cameroonian trauma patients was implemented as a first step toward identifying targets for systems modification.MethodsA QI committee composed of multidisciplinary experts at four hospitals in Cameroon was formed to review adverse events including deaths among trauma patients from 2019 to 2021. Events were discussed at newly established morbidity and mortality conferences and committee meetings to identify contributing factors and overall preventability.ResultsDuring 50 meetings, 95 adverse events were reviewed, including 58 deaths (61%). Other adverse events were delays in diagnosis/treatment (22%) and surgical site infections (17%). Overall, 34 deaths (59%) were classified as preventable, 21% potentially preventable, and 21% not preventable. Over half (52%) of the 46 preventable or potentially preventable deaths occurred in the emergency department (ED); while brain injury (57%), respiratory failure (41%), and hemorrhage (39%) were the most frequent physiologic factors associated with mortality. Contributory factors identified include lack of a structured approach to patient management, absence of continuous training for personnel, and locally adapted protocols.ConclusionsBasic improvements in evaluation and management of life‐threatening issues in the ED can significantly reduce the high rate of preventable trauma‐related deaths across Cameroon. Formal trauma QI methods can be utilized in low‐resource environments to determine mortality root causes and identify intervention targets.

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