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World J Surg (2014) 38:28042812 DOI 10.1007/s00268-014-2705-x
ORIGINAL SCIENTIFIC REPORT
Time-Based Trauma-Related Mortality Patterns in a Newly Created Trauma System
Husham Abdelrahman Ayman El-Menyar Hassan Al-Thani Rafael Consunji
Ahmad Zarour Ruben Peralta Ashok Parchani Rifat Lati
Published online: 7 August 2014 Socit Internationale de Chirurgie 2014
AbstractBackground Data on time-based trauma mortality (TTM) patterns in developing countries are lacking. Objective Our objective was to analyze the TTM in a newly established trauma center.
Methods A retrospective analysis of all trauma-related mortality between 2010 and 2012 was conducted in Qatar. Based on the time of injury, deceased cases were categorized into immediate (pre-hospital), early (rst 24 h), and late ([24 h) groups. TTM was analyzed and compared.
Results A total of 4,966 trauma patients were admitted to the trauma center over 3 years; of them, 333 trauma-related deaths (6.8 %) were documented and reviewed. The death pattern peaked immediately post-trauma (n = 142), followed by 96 deaths within the rst 24 h, 19 deaths within the time period[24 to 48 h, 50 deaths within the 3rd and 7th day (second peak), and 26 deaths after the 1st week. The majority of the deceased were males, with a mean age of 36 17 years. Motor vehicle crashes (43.5 %) were the commonest mechanism of injury. At presentation, median injury severity score (ISS) was 32 (range 975). Bleeding, abdominal, and pelvic injuries were higher in the early group, whereas head injuries were observed more in the late mortality group. Co-morbidities and in-hospital complications were predominantly encountered in the late group. Head injury (odds ratio [OR] 3.760; 95 % condence interval [CI] 1.31110.797) was an independent predictor for late death, whereas the need for blood transfusion was a predictor for early death (OR 3.233; 95 % CI 1.1259.345).
Conclusion The distribution of mortality shows a bimodal pattern. The high rate of death at the scene highlights the importance of pre-hospital care and the need for injury prevention programs.
Introduction
Worldwide, trauma is the third leading cause of death for all age groups and particularly in the rst 4 decades of life [1]. Namely, road trafc-related injuries (RTI), domestic violence, and suicide are the main causes of trauma-related deaths [2]. A signicant proportion of severely injured patients often die before...