TY  - JOUR
PY  - 2021//
TI  - Characteristics of prehospital death in trauma victims
JO  - Journal of clinical medicine
A1  - Gewiess, J.
A1  - Albers, C.E.
A1  - Pape, H.-c.
A1  - Bangerter, H.
A1  - Zech, W.-d.
A1  - Keel, M.J.B.
A1  - Bastian, J.D.
SP  - 
EP  - 
VL  - 10
IS  - 20
N2  - BACKGROUND: Using Injury Severity Score (ISS) data, this study aimed to give an overview of trauma mechanisms, causes of death, injury patterns, and potential survivability in prehospital trauma victims. <br><br>METHODS: Age, gender, trauma mechanism, cause of death, and ISS data were recorded regarding forensic autopsies and whole-body postmortem CT. Characteristics were analyzed for injuries considered potentially survivable at cutoffs of (I) ISS ≤ 75 vs. ISS = 75, (II) ISS ≤ 49 vs. ISS ≥ 50, and (III) ISS < lethal dose 50% (LD50) vs. ISS > LD50 according to Bull's probit model. <br><br>RESULTS: In n = 130 prehospital trauma victims (45.3 ± 19.5 years), median ISS was 66. Severity of injuries to the head/neck and chest was greater compared to other regions (p < 0.001). 52% died from central nervous system (CNS) injury. Increasing injury severity in head/neck region was associated with CNS-injury related death (odds ratio (OR) 2.7, confidence interval (CI) 1.8-4.4). Potentially survivable trauma was identified in (I) 56%, (II) 22%, and (III) 9%. Victims with ISS ≤ 75, ISS ≤ 49, and ISS < LD50 had lower injury severity across most ISS body regions compared to their respective counterparts (p < 0.05). <br><br>CONCLUSION: In prehospital trauma victims, injury severity is high. Lethal injuries predominate in the head/neck and chest regions and are associated with CNS-related death. The appreciable amount (9-56%) of victims dying at presumably survivable injury severity encourages perpetual efforts for improvement in the rescue of highly traumatized patients. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.<p /> <p>Language: en</p>
LA  - en
SN  - 2077-0383
UR  - http://dx.doi.org/10.3390/jcm10204765
ID  - ref1
ER  -