Epidemiology of in-hospital trauma deaths

R Lefering; T Paffrath; O Bouamra; T J Coats; M Woodford; T Jenks; A Wafaisade; U Nienaber; F Lecky

doi:10.1007/s00068-011-0168-4

Epidemiology of in-hospital trauma deaths

R Lefering, T Paffrath, O Bouamra, T J Coats, M Woodford, T Jenks, A Wafaisade, U Nienaber, F Lecky

Division of Population Health, Health Services Research & Primary Care (L5)

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	3-9
Number of pages	7
Journal	European Journal of Trauma and Emergency Surgery
Volume	38
Issue number	1
DOIs	https://doi.org/10.1007/s00068-011-0168-4
Publication status	Published - Feb 2012

Keywords

Severe injuries
Trauma
Cause of death
Mortality
Trauma registry

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10.1007/s00068-011-0168-4

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title = "Epidemiology of in-hospital trauma deaths",

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.",

keywords = "Severe injuries, Trauma, Cause of death, Mortality, Trauma registry",

author = "R Lefering and T Paffrath and O Bouamra and Coats, {T J} and M Woodford and T Jenks and A Wafaisade and U Nienaber and F Lecky",

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AU - Lefering, R

AU - Paffrath, T

AU - Bouamra, O

AU - Coats, T J

AU - Woodford, M

AU - Jenks, T

AU - Wafaisade, A

AU - Nienaber, U

AU - Lecky, F

PY - 2012/2

Y1 - 2012/2

N2 - 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.

AB - 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.

KW - Severe injuries

KW - Trauma

KW - Cause of death

KW - Mortality

KW - Trauma registry

U2 - 10.1007/s00068-011-0168-4

DO - 10.1007/s00068-011-0168-4

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C2 - 26815666

SN - 1863-9933

VL - 38

SP - 3

EP - 9

JO - European Journal of Trauma and Emergency Surgery

JF - European Journal of Trauma and Emergency Surgery

IS - 1

ER -

Epidemiology of in-hospital trauma deaths

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Keywords

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