Trauma fatalities

Δημητριάδης, Δημήτριος; Murray, James A.; Charalambides, Kiriakos; Alo, Kathy; Velmahos, George; Rhee, Peter; Chan, Linda S.

doi:10.1016/j.jamcollsurg.2003.09.003

Cited by 261 publications

(95 citation statements)

References 10 publications

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“…It can be noted that deaths caused by penetrating trauma occurred in younger individuals, but in the elderly, over 60 years of age, it was noted that almost all patients were victims of blunt trauma, mainly caused by road accidents. This also agrees with international literature [6,15]. …”

Section: Discussionsupporting

confidence: 93%

“…It is known that the distribution of times and locations of in-hospital deaths from trauma are influenced by cause of injury, age and injured body areas [6-12]. …”

Section: Introductionmentioning

confidence: 99%

“…Hemorrhagic shock is the second most frequent cause of death, ranging from 20% to 40% in some series, depending on the rate of penetrating trauma victims at the specific region [6,7,10-12]. Traumatic deaths occurring beyond the expected time have been used as a parameter to assess the quality of care of trauma patients.…”

Section: Introductionmentioning

confidence: 99%

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

2014

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BackgroundThe analysis of patterns of trauma deaths may improve the evaluation of a trauma system and identify areas that may benefit from more resources. The objective of this study was to analyze the epidemiology of trauma deaths in a Brazilian university hospital in order to assess the profile of these fatalities over a 16-year period.MethodRetrospective study of time series using database records. The research subjects were in-hospital deaths from external causes during the years 1995, 2000, 2005 and 2010. The following variables were analyzed: cause of injury, trauma scores, time and cause of death.Results467 cases were studied, being 325 patients (69.6%) admitted with signs of life and 142 (30.4%) considered dead on arrival. The mean age was 35.35 ± 18.03 years. 85.4% were males. Blunt trauma occurred in 73.0% of cases and penetrating mechanism in 27.0%. There was a significant increase (p < 0.001) in deaths from motorcycle crashes over the years, which went from 7.3% in 1995 to 31.5% in 2010. In contrast, there was a significant decrease (p = 0.030) in firearm-injury victims; from 21.0% in 1995 to 9.6% in 2010. About 60% of deaths occurred less than 24 hours after admission. The main causes of death were lesions of the central nervous system (56.3% of the total), followed by hemorrhagic shock (18.1%) and sepsis/multiple organ dysfunction syndrome (17.1%). The mean Injury Severity Score (ISS) of patients with signs of life was 26.41 ± 9.00, 71.3% of whom had ISS >25. The mean Revised Trauma Score (RTS) was 5.24 ± 2.05. Only 25.8% of the deaths had TRISS <0.50.ConclusionThere was a shift in the profile of causes of death from trauma in this university teaching hospital, with a large decrease in penetrating injuries and a higher incidence of deaths of motorcycle riders.

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Section: Discussionsupporting

confidence: 93%

“…It is known that the distribution of times and locations of in-hospital deaths from trauma are influenced by cause of injury, age and injured body areas [6-12]. …”

Section: Introductionmentioning

confidence: 99%

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

2014

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“…Worldwide, injuries kill nearly 6 million people annually and cause harm to millions more, accounting for 10% of global mortality (3). Despite numerous advancements in trauma care, a recent multinational trial of more than 20,000 patients (4) once again demonstrated that majority of deaths still occur within the first few hours after injuries, with about half due to massive blood loss (5–8), making this the number one cause of preventable deaths. To improve outcomes we must develop more effective pre-hospital treatments.…”

Section: Introductionmentioning

confidence: 99%

Creating a “Prosurvival Phenotype” Through Histone Deacetylase Inhibition

Halaweish

Nikolian

Georgoff

et al. 2015

Shock

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Traumatic injuries and their sequela represent a major source of mortality in the United States and globally. Initial treatment for shock, traumatic brain injury, and polytrauma is limited to resuscitation fluids to replace lost volume. To date, there are no treatments with inherent pro-survival properties. Our lab has investigated the use of histone deacetylase inhibitors (HDACIs) as pharmacological agents to improve survival. This class of drugs acts through posttranslational protein modifications and is a direct regulator of chromatin structure and function, as well as the function of numerous cytoplasmic proteins. In models of hemorrhagic shock and polytrauma, administration of HDACIs offers a significant survival advantage, even in the absence of fluid resuscitation. Positive results have also been shown in two-hit models of hemorrhage and sepsis and in hemorrhagic shock combined with traumatic brain injury. Accumulating data generated by our group and others continue to support the use of HDACIs for creation of a pro-survival phenotype. With further research and clinical trials, HDACIs have the potential to be an integral tool in treatment of trauma, especially in the pre-hospital phase.

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“…The major cause of death in trauma patients is central nervous system injury. The second most common and possibly preventable factor in many of these deaths is exsanguination[2]. In recent years, damage control strategies have been increasingly used in the care of the severely injured trauma patient.…”

Section: Introductionmentioning

confidence: 99%

Hypotensive Resuscitation

Smith

Pittet

Pierce

2014

Curr Anesthesiol Rep

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Hypotensive resuscitation is a component of damage control resuscitation, the evolving approach to resuscitation in severely injured trauma patients. Resuscitation strategies used in treating severely injured trauma patients have changed dramatically over the last 20 years. The purpose of this review is to examine the current literature pertaining to hypotensive resuscitation, explore its use in damage control resuscitation, and examine blood pressure management in the setting of severe trauma.

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Trauma fatalities

Cited by 261 publications

References 10 publications

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

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

Creating a “Prosurvival Phenotype” Through Histone Deacetylase Inhibition

Hypotensive Resuscitation

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