Trauma fatalities: Time and location of hospital deaths

Demetrios Demetriades, James Murray, Kiriakos Charalambides, Kathy Alo, George Velmahos, Peter M Rhee, Linda Chan

Research output: Contribution to journalArticle

179 Citations (Scopus)

Abstract

BACKGROUND: Analysis of the epidemiology, temporal distribution, and place of traumatic hospital deaths can be a useful tool in identifying areas for research, education, and allocation of resources. STUDY DESIGN: Trauma registry-based study of all traumatic hospital deaths at a Level I urban trauma center during the period 1993 to 2002. The time and hospital location where deaths occurred were analyzed according to mechanism of injury, age, Glasgow Coma Score, and body areas with severe injury (Abbreviated Injury Scale [AIS] ≥ 4). Logistic regression analysis was used to identify risk factors associated with death at various times after admission. RESULTS: During the study period there were 2,648 hospital trauma deaths. The most common body area with critical injuries (AIS ≥ 4) was the head (43%), followed by the chest (28%) and the abdomen (19%). Overall, 37% of victims had no vital signs present on admission. Chest AIS ≥ 4, penetrating trauma, and age greater than 60 years were significant risk factors associated with no vital signs on admission. Patients with severe chest trauma (AIS ≥ 4) reaching the hospital alive were significantly more likely to die within the first 60 minutes than were patients with severe abdominal or head injuries (17% versus 11% versus 7%). In patients reaching the hospital alive, the time and place of death varied according to mechanism of injury and injured body area. Deaths caused by severe head trauma peaked at 6 to 24 hours, and deaths caused by severe chest or abdominal trauma peaked at 1 to 6 hours after admission. CONCLUSIONS: The temporal distribution and location of trauma deaths are influenced by the mechanism of injury, age, and the injured body area. These findings may help in focusing research, education, and resource allocation in a more targeted manner to reduce trauma deaths.

Original languageEnglish (US)
Pages (from-to)20-26
Number of pages7
JournalJournal of the American College of Surgeons
Volume198
Issue number1
DOIs
StatePublished - Jan 2004
Externally publishedYes

Fingerprint

Wounds and Injuries
Abbreviated Injury Scale
Thorax
Resource Allocation
Vital Signs
Craniocerebral Trauma
Education
Abdominal Injuries
Thoracic Injuries
Trauma Centers
Coma
Research
Abdomen
Registries
Epidemiology
Logistic Models
Head
Regression Analysis

ASJC Scopus subject areas

  • Surgery

Cite this

Demetriades, D., Murray, J., Charalambides, K., Alo, K., Velmahos, G., Rhee, P. M., & Chan, L. (2004). Trauma fatalities: Time and location of hospital deaths. Journal of the American College of Surgeons, 198(1), 20-26. https://doi.org/10.1016/j.jamcollsurg.2003.09.003

Trauma fatalities : Time and location of hospital deaths. / Demetriades, Demetrios; Murray, James; Charalambides, Kiriakos; Alo, Kathy; Velmahos, George; Rhee, Peter M; Chan, Linda.

In: Journal of the American College of Surgeons, Vol. 198, No. 1, 01.2004, p. 20-26.

Research output: Contribution to journalArticle

Demetriades, D, Murray, J, Charalambides, K, Alo, K, Velmahos, G, Rhee, PM & Chan, L 2004, 'Trauma fatalities: Time and location of hospital deaths', Journal of the American College of Surgeons, vol. 198, no. 1, pp. 20-26. https://doi.org/10.1016/j.jamcollsurg.2003.09.003
Demetriades, Demetrios ; Murray, James ; Charalambides, Kiriakos ; Alo, Kathy ; Velmahos, George ; Rhee, Peter M ; Chan, Linda. / Trauma fatalities : Time and location of hospital deaths. In: Journal of the American College of Surgeons. 2004 ; Vol. 198, No. 1. pp. 20-26.
@article{322403572abd4b2fad881ccd016267c6,
title = "Trauma fatalities: Time and location of hospital deaths",
abstract = "BACKGROUND: Analysis of the epidemiology, temporal distribution, and place of traumatic hospital deaths can be a useful tool in identifying areas for research, education, and allocation of resources. STUDY DESIGN: Trauma registry-based study of all traumatic hospital deaths at a Level I urban trauma center during the period 1993 to 2002. The time and hospital location where deaths occurred were analyzed according to mechanism of injury, age, Glasgow Coma Score, and body areas with severe injury (Abbreviated Injury Scale [AIS] ≥ 4). Logistic regression analysis was used to identify risk factors associated with death at various times after admission. RESULTS: During the study period there were 2,648 hospital trauma deaths. The most common body area with critical injuries (AIS ≥ 4) was the head (43{\%}), followed by the chest (28{\%}) and the abdomen (19{\%}). Overall, 37{\%} of victims had no vital signs present on admission. Chest AIS ≥ 4, penetrating trauma, and age greater than 60 years were significant risk factors associated with no vital signs on admission. Patients with severe chest trauma (AIS ≥ 4) reaching the hospital alive were significantly more likely to die within the first 60 minutes than were patients with severe abdominal or head injuries (17{\%} versus 11{\%} versus 7{\%}). In patients reaching the hospital alive, the time and place of death varied according to mechanism of injury and injured body area. Deaths caused by severe head trauma peaked at 6 to 24 hours, and deaths caused by severe chest or abdominal trauma peaked at 1 to 6 hours after admission. CONCLUSIONS: The temporal distribution and location of trauma deaths are influenced by the mechanism of injury, age, and the injured body area. These findings may help in focusing research, education, and resource allocation in a more targeted manner to reduce trauma deaths.",
author = "Demetrios Demetriades and James Murray and Kiriakos Charalambides and Kathy Alo and George Velmahos and Rhee, {Peter M} and Linda Chan",
year = "2004",
month = "1",
doi = "10.1016/j.jamcollsurg.2003.09.003",
language = "English (US)",
volume = "198",
pages = "20--26",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Trauma fatalities

T2 - Time and location of hospital deaths

AU - Demetriades, Demetrios

AU - Murray, James

AU - Charalambides, Kiriakos

AU - Alo, Kathy

AU - Velmahos, George

AU - Rhee, Peter M

AU - Chan, Linda

PY - 2004/1

Y1 - 2004/1

N2 - BACKGROUND: Analysis of the epidemiology, temporal distribution, and place of traumatic hospital deaths can be a useful tool in identifying areas for research, education, and allocation of resources. STUDY DESIGN: Trauma registry-based study of all traumatic hospital deaths at a Level I urban trauma center during the period 1993 to 2002. The time and hospital location where deaths occurred were analyzed according to mechanism of injury, age, Glasgow Coma Score, and body areas with severe injury (Abbreviated Injury Scale [AIS] ≥ 4). Logistic regression analysis was used to identify risk factors associated with death at various times after admission. RESULTS: During the study period there were 2,648 hospital trauma deaths. The most common body area with critical injuries (AIS ≥ 4) was the head (43%), followed by the chest (28%) and the abdomen (19%). Overall, 37% of victims had no vital signs present on admission. Chest AIS ≥ 4, penetrating trauma, and age greater than 60 years were significant risk factors associated with no vital signs on admission. Patients with severe chest trauma (AIS ≥ 4) reaching the hospital alive were significantly more likely to die within the first 60 minutes than were patients with severe abdominal or head injuries (17% versus 11% versus 7%). In patients reaching the hospital alive, the time and place of death varied according to mechanism of injury and injured body area. Deaths caused by severe head trauma peaked at 6 to 24 hours, and deaths caused by severe chest or abdominal trauma peaked at 1 to 6 hours after admission. CONCLUSIONS: The temporal distribution and location of trauma deaths are influenced by the mechanism of injury, age, and the injured body area. These findings may help in focusing research, education, and resource allocation in a more targeted manner to reduce trauma deaths.

AB - BACKGROUND: Analysis of the epidemiology, temporal distribution, and place of traumatic hospital deaths can be a useful tool in identifying areas for research, education, and allocation of resources. STUDY DESIGN: Trauma registry-based study of all traumatic hospital deaths at a Level I urban trauma center during the period 1993 to 2002. The time and hospital location where deaths occurred were analyzed according to mechanism of injury, age, Glasgow Coma Score, and body areas with severe injury (Abbreviated Injury Scale [AIS] ≥ 4). Logistic regression analysis was used to identify risk factors associated with death at various times after admission. RESULTS: During the study period there were 2,648 hospital trauma deaths. The most common body area with critical injuries (AIS ≥ 4) was the head (43%), followed by the chest (28%) and the abdomen (19%). Overall, 37% of victims had no vital signs present on admission. Chest AIS ≥ 4, penetrating trauma, and age greater than 60 years were significant risk factors associated with no vital signs on admission. Patients with severe chest trauma (AIS ≥ 4) reaching the hospital alive were significantly more likely to die within the first 60 minutes than were patients with severe abdominal or head injuries (17% versus 11% versus 7%). In patients reaching the hospital alive, the time and place of death varied according to mechanism of injury and injured body area. Deaths caused by severe head trauma peaked at 6 to 24 hours, and deaths caused by severe chest or abdominal trauma peaked at 1 to 6 hours after admission. CONCLUSIONS: The temporal distribution and location of trauma deaths are influenced by the mechanism of injury, age, and the injured body area. These findings may help in focusing research, education, and resource allocation in a more targeted manner to reduce trauma deaths.

UR - http://www.scopus.com/inward/record.url?scp=1042299129&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1042299129&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2003.09.003

DO - 10.1016/j.jamcollsurg.2003.09.003

M3 - Article

C2 - 14698307

AN - SCOPUS:1042299129

VL - 198

SP - 20

EP - 26

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 1

ER -