Potentially preventable trauma deaths: A retrospective review

Beck, Ben; Smith, Karen; Mercier, Éric; Bernard, Stephen; Jones, Colin; Meadley, Ben; Clair, Toby St; Jennings, Paul; Nehme, Ziad; Burke, Michael P.; Bassed, Richard; Fitzgerald, Mark; Judson, Rodney; Teague, Warwick J.; Mitra, Biswadev; Mathew, Joseph; Buck, Andrew; Varma, Dinesh; Gabbe, Belinda; Bray, Janet; McLellan, Susan; Ford, Jane; Siedenburg, Josine; Cameron, Peter

doi:10.1016/j.injury.2019.03.003

Cited by 32 publications

(23 citation statements)

References 43 publications

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“…Although male victims like other studies were dominant (77 vs. 23%), 3,6,11,15,[17][18][19][20][21] younger ages and being male or female didn't in uence on survival probability in this study. However, opponents considered whether being female or being over 60-65 years could decrease survival rate.…”

Section: Discussioncontrasting

confidence: 55%

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Prevalence and Factors Predicting Preventable Trauma Induced Mortality

Hajian

Davoodabadi

Kashi

et al. 2021

Preprint

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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.Materials and 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 (ISS), revised trauma score (RTS) and probability of survival (Ps) based on TRISS method for each case were calculated. Eventually preventable and non-preventable death groups were compared.Results: Finally from the all 413 trauma victims 246(54.9%) files were enrolled. Victims aged from 18 to 95 years. Of all 189(76.8%) were males. Analysis manifested 135(54.9%) of all deaths were potentially and 2(0.08%) were certainly preventable; while the other 49.1% were non-preventable for expiration(p=0.001). Data showed that from all variables systolic blood pressure (SBP) ≥80mmHg, respiratory rate (RR) ≥20 per minute, GCS ≥8, higher RTS, road traffic accidents and control of external bleeding were contribute to prediction of preventable trauma related mortality.Conclusion: This study implied on frequency of trauma related preventable death was regionally high and associated factors that could be lessen the number of these mortalities including of SBP, RR, GCS, RTS, mechanism of trauma and external bleeding of trauma patients should be paid more attention.Trial registration: Retrospectively registered.

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Section: Discussioncontrasting

confidence: 55%

“…3 In case of certainly preventable death which in this study was 0.8%, other stated statistic was varied 0.5-4.2%. 13,15,[17][18][19] Notwithstanding the goal of trauma health care systems should be decrease PDs to as least as possible.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Factors Predicting Preventable Trauma Induced Mortality

Hajian

Davoodabadi

Kashi

et al. 2021

Preprint

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“…While the focus of this study was to investigate the epidemiology of in-hospital and out-of-hospital trauma deaths, reviewing out-of-hospital trauma deaths provides an opportunity to examine the entire system of care provided to trauma patients, not limited to those that survive to hospital. We have previously used an expert panel review methodology to identify opportunities to reduce trauma mortality,[40, 41] and recommend that all trauma systems consider utilising a similar methodology to improve systems of care.…”

Section: Discussionmentioning

confidence: 99%

Differences in the epidemiology of out-of-hospital and in-hospital trauma deaths

et al. 2019

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Background Trauma is a leading cause of mortality. Holistic views of trauma systems consider injury as a public health problem that requires efforts in primary, secondary and tertiary prevention. However, the performance of trauma systems is commonly judged on the in-hospital mortality rate. Such a focus misses opportunities to consider all deaths within a population, to understand differences in in-hospital and out-of-hospital trauma deaths and to inform population-level injury prevention efforts. The aim of this study was to provide an epidemiological overview of out-of-hospital and in-hospital trauma deaths in a geographically-defined area over a 10-year period. Methods We performed a population-based review of out-of-hospital and in-hospital trauma deaths over the period of 01 July 2006 to 30 June 2016 in Victoria, Australia, using data from the National Coronial Information System and the Victorian State Trauma Registry. Temporal trends in population-based incidence rates were evaluated. Results Over the study period, there were 11,246 trauma deaths, of which 71% were out-of-hospital deaths. Out-of-hospital trauma deaths commonly resulted from intentional self-harm events (50%) and transport events (35%), while in-hospital trauma deaths commonly resulted from low falls (≤1 metre) (50%). The incidence of overall trauma deaths did not change over the study period (incidence rate ratio 0.998; 95%CI: 0.991, 1.004; P = 0.56). Conclusions Out-of-hospital deaths accounted for most trauma deaths. Given the notable differences between out-of-hospital and in-hospital trauma deaths, monitoring of all trauma deaths is necessary to inform injury prevention activities and to reduce trauma mortality. The absence of a change in the incidence of both out-of-hospital and in-hospital trauma deaths demonstrates the need for enhanced activities across all aspects of injury prevention.

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“…NSW has a geographic land mass of 801 150 km 2 ; by comparison, the Australian state of Victoria has a land mass of 227 444km 2 . Beck et al 11 cite long response times as a contributing factor in 20% of potentially preventable or preventable trauma deaths in Victoria; however the length of time was not described. In the United States, as many as 50% of hemorrhagic deaths were deemed to be preventable or potentially preventable with 36% not surviving to the hospital 12 .…”

Section: Discussionmentioning

confidence: 99%

Retrieval transfusion protocol in New South Wales, Australia: A retrospective review of the first 5 years

et al. 2020

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Background: Ambulance service blood transfusion is an area of rapid development. In New South Wales, Australia, the blood products carried by ambulance medical teams are often the first available to patients with critical bleeding. In addition to the blood products routinely carried by these teams, the Service created and implemented a method of initiating large-volume, mixed-product transfusions using existing blood banks: the Retrieval Transfusion Procedure (RTP). This article describes the trends and characteristics of New South Wales Ambulance RTP activations. Materials and Methods: This retrospective database review examines the patient records for all RTP activations. Key areas of investigation include logistics, product requests, population demographics, etiologies, physiology, mission timings, and transfusions. Results: Ambulance medical teams attended 27 531 missions in the reviewed period, 1573 patients received transfusion, and there were 138 RTP activations. Blood products were sourced from 40 banks and transported by police (46.7%), ambulance (27.1%), and helicopter (13.0%) to refueling stops (39.2%), prehospital scenes (24.2%) and hospitals (15.8%). The median time engaged on each mission was 189 minutes for metropolitan and 222 minutes for rural locations. Seventy-eight patients were transfused with RTP blood products; 83.3% were traumas, of which 63.1% were motor vehicle collisions. Up to 18 units of blood products were administered before hospital arrival. There was significant (P < .001) improvement in the mean shock index of transfused patients between the first and final observations recorded. Conclusions: Ambulance service extended blood product transfusion is logistically achievable and facilitates emergency transfusions throughout the state with minimal additional infrastructure.

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Potentially preventable trauma deaths: A retrospective review

Abstract: The number of potentially preventable or preventable trauma deaths in the pre-hospital and early in-hospital resuscitation phase was low. Specific circumstances were identified in which the trauma system could be further improved.

Cited by 32 publications

References 43 publications

Prevalence and Factors Predicting Preventable Trauma Induced Mortality

Prevalence and Factors Predicting Preventable Trauma Induced Mortality

Differences in the epidemiology of out-of-hospital and in-hospital trauma deaths

Retrieval transfusion protocol in New South Wales, Australia: A retrospective review of the first 5 years

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