Trauma - Reason for Death

The first peak within the classic trimodal model of trauma mortality is immediate death occurring within minutes of the injury. These patients are declared dead on the scene or die shortly when arriving at the hospital. In most revealed reports, these embrace deaths at the scene, deaths occurring within one hour of arrival to the hospital.

These deaths are usually a consequence of severe injuries. The seminal works of Baker et al and Trunkey in the Seventies showed that 64% of trauma deaths occurred on the scene, with the patients not even transported to a hospital.

Despite all the progress in emergency medical services and trauma systems, pre-hospital care, injury interference, and automotive safety, the proportion of deaths occurring in real-time when the injury has remained unchanged over time.

The second peak within the trimodal distribution is early deaths, outlined as deaths within hours of arrival to the hospital. In most revealed reports, early deaths embrace deaths within twenty-four hours of arrival to a trauma center, excluding immediate deaths. These deaths also are a consequence of severe injuries; however, the patients reach the hospital alive and the injury is probably treatable with prompt definitive care.

Deaths among trauma patients after discharge have gone unnoticed.  This can be due to the issue of follow-up within the trauma patient population. First, the patient stays far from a trauma center. Second, trauma patients are usually younger people who stay away from home for education or work. Many studies have shown that trauma patients have a magnified risk of mortality when discharged.

CAUSES OF DEATH DUE TO TRAUMA

Several studies have investigated the reason for death in trauma patients. It was found that brain injury accounted for a majority of deaths [50%], Heart or aortal injury (17%), hemorrhage (12%), infection (10%), respiratory organ injury (6%), burn (3%), and liver injury (2%) accounted for the rest. The majority of patients with an internal organ, vascular, or liver injury died of hemorrhage.

                                                           Figure 1: Cause of death in trauma patients

Head injury was the foremost common cause of death. Almost a 3rd (31%) of victims died of hemorrhage within the chest, the abdomen, or inside the organ.

Lack of pre-hospital care and shorter transport times to trauma centers remains the reasons for death in a grievous injury.