Talk and Die: A Descriptive Analysis of Penetrating Trauma Patients

Abstract

Introduction“Talk and die” traditionally described occult presentations of fatal intracranial injuries, but we broaden its definition to victims of penetrating trauma. MethodsWe conducted a descriptive analysis of patients with penetrating torso trauma who presented with a Glasgow Coma Scale verbal score ≥3 and died within 48 h of arrival from 2008 to 2018. ResultsSixty patients were identified. Eighteen (30.0%) required resuscitative thoracotomy with 7 (11.7%) dying in the trauma bay. Fifty-three (86.9%) patients went to the operating room, and 35 (66.0%) required multicavitary exploration. The most common injuries were hollow viscous (58.5%), intra-abdominal vascular (49.0%), liver (28.3%), pulmonary (26.4%), intrathoracic vascular (18.9%), and cardiac (15.75) injuries. Twenty-three (43.4%) patients survived their initial operation, but died in the first 48 h postoperatively. ConclusionsPatients who “talk and die” most frequently have intra-abdominal vascular injures and require multicavitary exploration.