Temporal Patterns of Trauma Mortality and Causes of Death in a Level 1 Trauma Center: Implications for Improved Trauma Care.

Abstract

Introduction: Trauma mortality patterns have evolved over time, with distinct phases of immediate, early, and late deaths. Advances in trauma care and changing injury dynamics have contributed to shifts in this pattern. Understanding the causes and timing of trauma deaths is pivotal for enhancing trauma care systems.

Materials and methods: We conducted a retrospective analysis of trauma deaths in 2020-2022 at a level 1 trauma center. Trauma death data were collected from case records, wound certificates, and death certificates. The time of death from trauma was calculated and deaths were categorized into immediate, early (within 24 h), and late (after 24 h) groups. Statistical analyses, including Chi-square tests, were performed to assess associations.

Results: Of the 186 trauma deaths studied, 86.6% were males, and the mean age was 40 ± 16.91 years. Immediate deaths were predominantly due to brain injury (BI) (54.8%), thoracic injury (17.9%), and spinal cord injury (16.7%). Early deaths were mainly attributed to BI (35.1%) and poly-trauma (35.1%). Late deaths (after 24 h) were primarily a result of multiple organ failure (44.4%) and sepsis (24.4%). The analysis showed a significant association between the cause of death and time from trauma to death (P < 0.001).

Conclusion: BI emerged as the leading cause of trauma-related deaths, with a progressive decline pattern observed in a well-established trauma care center. Immediate deaths can potentially be reduced through trauma prevention strategies, particularly in the context of high-speed vehicles and machinery. These findings underscore the importance of timely interventions, effective critical care, and continuous improvements in trauma care systems.