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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

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  • Medientyp: E-Artikel
  • Titel: Characteristics of Prehospital Death in Trauma Victims
  • Beteiligte: Gewiess, Jan; Albers, Christoph Emanuel; Pape, Hans-Christoph; Bangerter, Hannes; Zech, Wolf-Dieter; Keel, Marius Johann Baptist; Bastian, Johannes Dominik
  • Erschienen: MDPI AG, 2021
  • Erschienen in: Journal of Clinical Medicine
  • Sprache: Englisch
  • DOI: 10.3390/jcm10204765
  • ISSN: 2077-0383
  • Schlagwörter: General Medicine
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:p>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 &lt; lethal dose 50% (LD50) vs. ISS &gt; 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 &lt; 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 &lt; LD50 had lower injury severity across most ISS body regions compared to their respective counterparts (p &lt; 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.</jats:p>
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