KMID : 1033220140040020067
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Journal of Acute Care Surgery 2014 Volume.4 No. 2 p.67 ~ p.72
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Patterns of In-hospital Mortality and Causes of Death in Blunt Poly-trauma Patients
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HongTae-Hwa
Lee Seung-Hwan Kim Hyung-Won Jung Myung-Jae Lee Jae-Gil
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Abstract
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Purpose: 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.
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KEYWORD
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Multiple trauma, Epidemiology, Mortality
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