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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Emergency Medicine 1/2014

Epidemiology of in-hospital trauma deaths in a Brazilian university hospital

Zeitschrift:
BMC Emergency Medicine > Ausgabe 1/2014
Autoren:
Adriano D Trajano, Bruno M Pereira, Gustavo P Fraga
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-227X-14-22) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

ADT participated in the acquisition, statistical analysis and interpretation of data, participated in the study’s design and drafted the manuscript. GPF conceived the study, and participated in its design and coordination and helped to draft the manuscript. BMP contributed to the study’s design and the revision of the manuscript. All authors read and approved the final manuscript.

Abstract

Background

The analysis of patterns of trauma deaths may improve the evaluation of a trauma system and identify areas that may benefit from more resources. The objective of this study was to analyze the epidemiology of trauma deaths in a Brazilian university hospital in order to assess the profile of these fatalities over a 16-year period.

Method

Retrospective study of time series using database records. The research subjects were in-hospital deaths from external causes during the years 1995, 2000, 2005 and 2010. The following variables were analyzed: cause of injury, trauma scores, time and cause of death.

Results

467 cases were studied, being 325 patients (69.6%) admitted with signs of life and 142 (30.4%) considered dead on arrival. The mean age was 35.35 ± 18.03 years. 85.4% were males. Blunt trauma occurred in 73.0% of cases and penetrating mechanism in 27.0%. There was a significant increase (p < 0.001) in deaths from motorcycle crashes over the years, which went from 7.3% in 1995 to 31.5% in 2010. In contrast, there was a significant decrease (p = 0.030) in firearm-injury victims; from 21.0% in 1995 to 9.6% in 2010. About 60% of deaths occurred less than 24 hours after admission. The main causes of death were lesions of the central nervous system (56.3% of the total), followed by hemorrhagic shock (18.1%) and sepsis/multiple organ dysfunction syndrome (17.1%). The mean Injury Severity Score (ISS) of patients with signs of life was 26.41 ± 9.00, 71.3% of whom had ISS >25. The mean Revised Trauma Score (RTS) was 5.24 ± 2.05. Only 25.8% of the deaths had TRISS <0.50.

Conclusion

There was a shift in the profile of causes of death from trauma in this university teaching hospital, with a large decrease in penetrating injuries and a higher incidence of deaths of motorcycle riders.
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