Abstract
BackgroundThe 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.MethodRetrospective 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.Results467 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.ConclusionThere 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.
Highlights
The analysis of patterns of trauma deaths may improve the evaluation of a trauma system and identify areas that may benefit from more resources
We retrospectively reviewed the charts of all in-hospital deaths from external causes during the years 1995, 2000, 2005 and 2010
It is concluded that the deaths due to trauma occurred predominantly in young people and those of the male gender, and that penetrating trauma was more common among the young and blunt trauma the elderly, where being run over constituted the major cause of death
Summary
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. External causes of death are a major challenge to public health authorities [1]. They account for more than five million deaths annually worldwide and cause temporary or permanent disability to millions more, representing about 9% of global mortality. External causes, including trauma, mainly affect people from 5 to 44 years old, usually males, living in poor and developing countries [3]. In 2010, Brazil registered 143,256 deaths from external causes, 21% more than in 2000 (118,397 deaths).
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