Predicting factors and incidence of preventable trauma induced mortality. (August 2021)

• Record Type: Journal Article
• Authors: Davoodabadi, Abdoulhosein; Abdorrahim Kashi, Esmail; Mohammadzadeh, Mahdi; Mousavi, Noushin; Shafagh, Shima; Ghafoor, Leila; Sehat, Mojtaba; Ale Mohammad, Shahrzad; Hajian, Abbas
• Is Part Of: Annals of medicine and surgery. Volume 68(2021)
• Publication Date: 2021-08
• Subjects: Death -- ISS -- Preventable -- Probability of survival -- Trauma; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102609
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Trauma is one of the most common causes of morbidity and mortality worldwide. Since the definition of preventable death has been described many studies like current one were conducted to evaluate this issue. Methods: This cohort retrospective study investigated archived medical files of trauma victims from 2017 to 2020 in a referral single-center trauma hospital. Registered demographic data, vital signs, Glasgow coma scale (GCS), timing of trauma and death, executed interventions, type and mechanism of trauma in addition to time errors, clinical mismanagements, and missed injuries were extracted. Injury severity score, revised trauma score, and probability of survival based on TRISS method for each case were calculated. Eventually preventable and non-preventable death were defined and compared. Results: Finally from the all 413 trauma deaths 246(54.9 %) files were enrolled. Dead persons were from 18 to 95 years. Of all 189(76.8 %) were males. Analysis manifested 135(54.9 %) of all deaths were potentially preventable and the rest 49.1 % was non-preventable for expiration(p = 0.001). Data showed that from all variables systolic blood pressure ≥80 mmHg, respiratory rate >19 per minute, GCS>8, higher RTS, road traffic accidents and control of external bleeding were contributed to prediction of preventable trauma related mortality. Conclusion: This study implied on that frequency of trauma related preventable death was regionally high and associating factors that could influence the number of these mortalities included systolic blood pressure, respiratory rate, GCS, revised trauma score, mechanism of trauma, and external bleeding of trauma patients. Highlights: Preventable trauma related mortality is achieved to 55 % in this study while World Health Organization considered 20 % averagely. Time errors, missing injuries, and clinical management errors were not generally attributed to preventable trauma death. SBP>80, RR>19, GCS>8, road-traffic accident, and adequate control of external bleeding could rescue patients from death.