Trends in Preventable Trauma Death Rates in Korea: A Follow-up Study of the Trauma System's Performance.

Background: The preventable trauma death rate (PTDR) is a key measure of trauma system performance. This study, the fourth follow-up since the implementation of trauma centers in South Korea, aimed to evaluate trends in PTDR and assess the mid-term performance of the trauma system. The study utilized consistent methods with previous analyses to ensure comparability and continuity.

Methods: A total of 8,490 trauma deaths occurred in 2021, and 1,688 patients from 265 medical institutions were included in the study. A multidisciplinary panel review was conducted to assess the preventability of mortality and identify opportunities for improvement. The results were compared with those from previous studies on the PTDR.

Results: Of the 1,688 sampled patients, the PTDR was calculated for 929. The overall PTDR was estimated at 13.9%, with a definitive preventable death rate of 2.9% and a potentially preventable death rate of 12.7%. The reduction in PTDR was not statistically significant compared to the 2019 study, which reported a rate of 15.7% (P = 0.261). Significant differences were observed between the preventable and non-preventable groups in terms of age, timing of death, level of medical institution, inter-hospital transfer, means of hospital admission, and time from accident to death.

Conclusion: In 2021, the PTDR was 13.9%, showing a slight reduction compared to the 2019 study. This study primarily evaluated the performance of Korea's trauma system, with findings highlighting both progress and persistent challenges. Although the study was conducted during the coronavirus disease 2019 pandemic, its potential indirect impact on trauma care is acknowledged as an area for further research. Addressing systemic limitations remains essential for further reducing preventable trauma deaths.