The Distribution of Time to Death in Trauma Patients

Lee, Dong Hoon; Noh, Hyun; Jung, Koo Young; Kim, Chan Woong; Lee, Hye Jean

Abstract

OBJECTIVE
In trauma patients, the distribution of time to death can be used in many ways. We examined the distribution of time to death in trauma patients who expired during a 10-year and analyzed the risk factors of early deaths. METHOD: From January 1994 to December 2003, trauma patients who had been admitted and had expired at tertiary hospitals were enrolled. A retrospective study was done to determine the distribution of trauma mortality and compared the differences between patients who succumbed during the first 5 years and those who succumbed during the second 5 years. We also analyzed the risk factors associated with early deaths that occurred within 6 hours after injury. RESULT: The distribution was bimodal for both the first and the second 5 years. During the second 5 years, there was about two times as many death within 1 hour after injury. The average ages were 36.5 years for the first 5 years and 43.6 years for the second 5 years (p<0.05). The transport times were 35 minutes for the first 5 years and 31.5 minutes for the second 5 years, and the transports by EMS (119) increased from 45.2% to 77.1%. Motor vehicle accidents were the most common mechanism of injury in both periods, but the number was lower in the second 5 years (p<0.05). The most common causes of death were injuries of head and spine and hemorrhages. Risk factor of early deaths were injury of nervous system and chest trauma.
CONCLUSION
In our study, the distribution of trauma mortality was bimodal pattern. The trauma system in Korea should be improved to decrease the early and the late peak. To decrease early deaths, it is important to prevent accident, develop EMS for early transport and pre-hospital management, and connect effectively with the trauma center. To decrease late deaths, aggressive resuscitation, suitable antibiotic therapy, and conservative treatment are important.