EPIDEMIOLOGY OF TRAUMA DEATHS - A REASSESSMENT
EPIDEMIOLOGY OF TRAUMA DEATHS - A REASSESSMENT
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DOI：
10.1097/00005373-199502000-00006
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发表时间：
1995-02-01
影响因子：
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通讯作者：
PONS, PT
中科院分区：
文献类型：
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作者：
SAUAIA, A;MOORE, FA;PONS, PT
目的：认识到 1977 年旧金山创伤死亡研究对创伤护理的影响，我们的目的是重新评估当代创伤系统中的这些发现。设计：横断面。材料和方法：对 1992 年丹佛市和县发生的所有创伤死亡进行了回顾；数据是通过交叉引用四个数据库获得的：护理人员旅行报告、创伤登记、验尸官尸检报告和警方报告。测量和主要结果：有 289 人受伤后死亡；平均年龄为 36.8 +/- 1.2 岁，平均损伤严重程度评分 (ISS) 为 35.7 +/- 1.2。主要伤害机制为枪伤（121 例（42%））、机动车事故（75 例（38%））和跌倒（23 例（8%））。七人 (2%) 遭受致命烧伤，九十八人 (34%) 死亡发生在院前环境中。其余 191 名（66%）患者被送往医院。其中，154 例（81%）在最初 48 小时内死亡（急性），11 例（6%）在 3 至 7 天内死亡（早期），26 例（14%）在 7 天后死亡（晚期）。中枢神经系统损伤是最常见的死亡原因（42%），其次是失血（39%）和器官衰竭（7%）。虽然急性和早期死亡主要是由于前两种原因，但器官衰竭是晚期死亡的最常见原因（61%）。 结论：与之前的报告相比，我们观察到相似的损伤机制、人口统计和死亡原因。然而，根据我们的经验，医疗系统的获取有所改善，因脑损伤导致的晚期死亡比例更高，并且缺乏经典的三峰分布。
Objective: Recognizing the impact of the 1977 San Francisco study of trauma deaths in trauma care, our purpose was to reassess those findings in a contemporary trauma system.Design: Cross-sectional.Material and Methods: All trauma deaths occurring in Denver City and County during 1992 were reviewed; data were obtained by cross-referencing four databases: paramedic trip reports, trauma registries, coroner autopsy reports and police reports.Measurements and Main Results: There were 289 postinjury fatalities; mean age was 36.8 +/- 1.2 years and mean Injury Severity Score (ISS) was 35.7 +/- 1.2. Predominant injury mechanisms were gunshot wounds in 121 (42%), motorvehicle accidents in 75 (38%) and falls in 23 (8%) cases. Seven (2%) individuals sustained lethal burns, Ninety eight (34%) deaths occurred in the pre-hospital setting. The remaining 191 (66%) patients were transported to the hospital. Of these, 154 (81%) died in the first 48 hours (acute), 11 (6%) within three to seven days (early) and 26 (14%) after seven days (late). Central nervous system injuries were the most frequent cause of death (42%), followed by exsanguination (39%) and organ failure (7%). While acute and early deaths were mostly due to the first two causes, organ failure was the most common cause of late death (61%).Conclusions: In comparison with the previous report, we observed similar injury mechanisms, demographics and causes of death. However, in our experience, there was an improved access to the medical system, greater proportion of late deaths due to brain injury and lack of the classic trimodal distribution.