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Epidemiology of in-hospital trauma deaths

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

About half of all trauma-related deaths occur after hospital admission. The present study tries to characterize trauma deaths according to the time of death, and, thereby, contributes to the discussion about factors considered as the cause of death.

Methods

Data from two large European trauma registries (Trauma Registry of the German Society of Trauma Surgery, TR-DGU, and the Trauma Audit and Research Network, TARN) were analyzed in parallel. All hospital deaths with Injury Severity Score (ISS) > 9 documented between 2000 and 2010 were considered. Patients were categorized into five subgroups according to the time to death (0–6 h; 7–24 h; day 1–6; day 7–30; beyond day 30). Surviving patients from the same time period served as a control group.

Results

In total, 6,685 and 6,867 non-survivors were included from the TR-DGU and TARN, respectively. The hospital mortality rate was between 15 and 17%. About half of all deaths occurred within the first 24 h after admission (TR-DGU: 54%; TARN: 45%). The earliest subgroup of trauma deaths showed the highest mean ISS and the highest rate of mass transfusions. Severe head injury was most frequently observed in the subgroup of day 1–6. Late deaths are associated with higher age and more complications (sepsis, multiple organ failure).

Conclusions

The time to death after severe trauma does not follow a trimodal distribution but shows a constantly decreasing incidence.

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Authors and Affiliations

  1. Institute for Research in Operative Medicine, University Witten/Herdecke, Ostmerheimer Str. 200, 51109, Cologne, Germany

    R. Lefering

  2. Trauma Audit and Research Network, Health Sciences Research Group, School of Community Based Medicine, Manchester Medical Academic Health Sciences Centre, University of Manchester, Salford Royal Hospital, Salford, UK

    O. Bouamra, M. Woodford, T. Jenks & F. Lecky

  3. Department for Trauma Surgery and Orthopaedics, Cologne Merheim Medical Center, University Witten/Herdecke, Cologne, Germany

    T. Paffrath & A. Wafaisade

  4. Akademie Unfallchirurgie (AUC) of the German Society for Trauma Surgery (DGU), Cologne, Germany

    U. Nienaber

  5. Emergency Medicine Academic Group, University of Leicester, Leicester, UK

    T. J. Coats

Authors
  1. R. Lefering
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  2. T. Paffrath
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  3. O. Bouamra
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  4. T. J. Coats
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  5. M. Woodford
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  6. T. Jenks
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  7. A. Wafaisade
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  8. U. Nienaber
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  9. F. Lecky
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Corresponding author

Correspondence to R. Lefering.

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Lefering, R., Paffrath, T., Bouamra, O. et al. Epidemiology of in-hospital trauma deaths. Eur J Trauma Emerg Surg 38, 3–9 (2012). https://doi.org/10.1007/s00068-011-0168-4

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  • DOI: https://doi.org/10.1007/s00068-011-0168-4

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