Mikkelsen Ronni, Møller Hansen Ole, Brink Ole
Ryhavevej 1A, 2. tv., 8210 Aarhus V, Danmark.
Dan Med J. 2014 Oct;61(10):A4928.
Knowledge of trauma patients is often based on US studies. However, these may not be representative of the Scandinavian population. Knowing which trauma patients are at risk of dying might help us target and optimise their treatment. The purpose of this study was to examine the epidemiological characteristics and the mortality among patients who did not survive after being admitted to a Danish trauma centre.
This was a historical cohort study. The study population comprised trauma patients admitted to Aarhus University Hospital from January 2000 to July 2011. Those admitted alive and who subsequently died while still at the hospital were analysed as dead. All injuries were scored according to the abbreviated injury scale, and the mechanisms of trauma were categorised by the NOMESCO classification system. The annual odds ratios (OR) for death were calculated adjusting for potential confounders using logistic regression analysis.
During the study period, a total of 6,299 trauma patients were admitted of whom 280 (4.4%) died. The OR for death was significantly lower in 2004 than in the remaining years, but there was no difference in mortality during the rest of the study period. Most patients died within the first 24 hours (67%), and 87% died within the first week. The primary cause of death was damage to the central nervous system (56%) and exsanguination (13%).
Survival has not been improved in the period from January 2000 to July 2011. Initiatives that could potentially improve survival include the introduction of an increased focus on older patients, treatment within the first 24 hours and treatment of cerebral and vascular injuries.
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