Document Detail

Preventable deaths from hemorrhage at a level I Canadian trauma center.
MedLine Citation:
PMID:  17215745     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Studies of trauma deaths have had a tremendous impact on the quality of contemporary trauma care. We studied causes of trauma death at a Level I Canadian trauma center, and tabulated preventable deaths from hemorrhage using explicit criteria. METHODS: Trauma registry data were used to identify all trauma deaths at our institution from January 1, 1999 to December 31, 2003. Demographics, mechanism, and time or location of death were recorded. Registry data analysis and selective chart or autopsy review were then performed to assign causes of death. RESULTS: A total of 558 consecutive trauma deaths were reviewed. Mean age was 48.7 (46.7-50.6), and mean Injury Severity Score was 38.8 (37.6-40.0); 29% were females. Blunt trauma represented 87% of all cases; penetrating injuries were only 13%. Central nervous system (CNS) injuries were the most frequent cause of death (60%), followed by hemorrhage (15%), and then combination CNS and hemorrhagic injuries (11%). Multiple organ failure caused 5% of deaths and 9% of deaths were from other causes. Of hemorrhagic deaths, 48% (n = 41) were from blunt injury, and 52% (n = 45) were from a penetrating mechanism. Of these hemorrhagic deaths, 16% were judged to be preventable because of significant delays in identifying the major source of hemorrhage. Hemorrhage from blunt pelvic injury was the major cause of exsanguination in 12 of 14 of these preventable deaths. CONCLUSIONS: Blunt injury is the major mechanism leading to trauma deaths. Massive bleeding from blunt pelvic injury is the major cause of preventable hemorrhagic deaths in our study.
Homer C Tien; Fernando Spencer; Lorraine N Tremblay; Sandro B Rizoli; Frederick D Brenneman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  62     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-11     Completed Date:  2007-02-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  142-6     Citation Subset:  AIM; IM    
Canadian Forces Health Services Group, Department of National Defense, Toronto, Canada.
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MeSH Terms
Aged, 80 and over
Cause of Death
Cohort Studies
Hemorrhage / etiology,  mortality*
Hospital Mortality*
Middle Aged
Ontario / epidemiology
Quality of Health Care*
Retrospective Studies
Trauma Centers / statistics & numerical data*
Wounds, Nonpenetrating / complications,  mortality*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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