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Characteristics of Prehospital Death in Trauma Victims

Background: Using Injury Severity Score (ISS) data, this study aimed to give an overview of trauma mechanisms, causes of death, injury patterns, and potential survivability in prehospital trauma victims. Methods: Age, gender, trauma mechanism, cause of death, and ISS data were recorded regarding for...

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Autores principales: Gewiess, Jan, Albers, Christoph Emanuel, Pape, Hans-Christoph, Bangerter, Hannes, Zech, Wolf-Dieter, Keel, Marius Johann Baptist, Bastian, Johannes Dominik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540414/
https://www.ncbi.nlm.nih.gov/pubmed/34682888
http://dx.doi.org/10.3390/jcm10204765
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author Gewiess, Jan
Albers, Christoph Emanuel
Pape, Hans-Christoph
Bangerter, Hannes
Zech, Wolf-Dieter
Keel, Marius Johann Baptist
Bastian, Johannes Dominik
author_facet Gewiess, Jan
Albers, Christoph Emanuel
Pape, Hans-Christoph
Bangerter, Hannes
Zech, Wolf-Dieter
Keel, Marius Johann Baptist
Bastian, Johannes Dominik
author_sort Gewiess, Jan
collection PubMed
description Background: Using Injury Severity Score (ISS) data, this study aimed to give an overview of trauma mechanisms, causes of death, injury patterns, and potential survivability in prehospital trauma victims. Methods: Age, gender, trauma mechanism, cause of death, and ISS data were recorded regarding forensic autopsies and whole-body postmortem CT. Characteristics were analyzed for injuries considered potentially survivable at cutoffs of (I) ISS ≤ 75 vs. ISS = 75, (II) ISS ≤ 49 vs. ISS ≥ 50, and (III) ISS < lethal dose 50% (LD50) vs. ISS > LD50 according to Bull’s probit model. Results: In n = 130 prehospital trauma victims (45.3 ± 19.5 years), median ISS was 66. Severity of injuries to the head/neck and chest was greater compared to other regions (p < 0.001). 52% died from central nervous system (CNS) injury. Increasing injury severity in head/neck region was associated with CNS-injury related death (odds ratio (OR) 2.7, confidence interval (CI) 1.8–4.4). Potentially survivable trauma was identified in (I) 56%, (II) 22%, and (III) 9%. Victims with ISS ≤ 75, ISS ≤ 49, and ISS < LD50 had lower injury severity across most ISS body regions compared to their respective counterparts (p < 0.05). Conclusion: In prehospital trauma victims, injury severity is high. Lethal injuries predominate in the head/neck and chest regions and are associated with CNS-related death. The appreciable amount (9–56%) of victims dying at presumably survivable injury severity encourages perpetual efforts for improvement in the rescue of highly traumatized patients.
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spelling pubmed-85404142021-10-24 Characteristics of Prehospital Death in Trauma Victims Gewiess, Jan Albers, Christoph Emanuel Pape, Hans-Christoph Bangerter, Hannes Zech, Wolf-Dieter Keel, Marius Johann Baptist Bastian, Johannes Dominik J Clin Med Article Background: Using Injury Severity Score (ISS) data, this study aimed to give an overview of trauma mechanisms, causes of death, injury patterns, and potential survivability in prehospital trauma victims. Methods: Age, gender, trauma mechanism, cause of death, and ISS data were recorded regarding forensic autopsies and whole-body postmortem CT. Characteristics were analyzed for injuries considered potentially survivable at cutoffs of (I) ISS ≤ 75 vs. ISS = 75, (II) ISS ≤ 49 vs. ISS ≥ 50, and (III) ISS < lethal dose 50% (LD50) vs. ISS > LD50 according to Bull’s probit model. Results: In n = 130 prehospital trauma victims (45.3 ± 19.5 years), median ISS was 66. Severity of injuries to the head/neck and chest was greater compared to other regions (p < 0.001). 52% died from central nervous system (CNS) injury. Increasing injury severity in head/neck region was associated with CNS-injury related death (odds ratio (OR) 2.7, confidence interval (CI) 1.8–4.4). Potentially survivable trauma was identified in (I) 56%, (II) 22%, and (III) 9%. Victims with ISS ≤ 75, ISS ≤ 49, and ISS < LD50 had lower injury severity across most ISS body regions compared to their respective counterparts (p < 0.05). Conclusion: In prehospital trauma victims, injury severity is high. Lethal injuries predominate in the head/neck and chest regions and are associated with CNS-related death. The appreciable amount (9–56%) of victims dying at presumably survivable injury severity encourages perpetual efforts for improvement in the rescue of highly traumatized patients. MDPI 2021-10-18 /pmc/articles/PMC8540414/ /pubmed/34682888 http://dx.doi.org/10.3390/jcm10204765 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gewiess, Jan
Albers, Christoph Emanuel
Pape, Hans-Christoph
Bangerter, Hannes
Zech, Wolf-Dieter
Keel, Marius Johann Baptist
Bastian, Johannes Dominik
Characteristics of Prehospital Death in Trauma Victims
title Characteristics of Prehospital Death in Trauma Victims
title_full Characteristics of Prehospital Death in Trauma Victims
title_fullStr Characteristics of Prehospital Death in Trauma Victims
title_full_unstemmed Characteristics of Prehospital Death in Trauma Victims
title_short Characteristics of Prehospital Death in Trauma Victims
title_sort characteristics of prehospital death in trauma victims
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540414/
https://www.ncbi.nlm.nih.gov/pubmed/34682888
http://dx.doi.org/10.3390/jcm10204765
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