A Five-year Review of Deaths following Urban Trauma

Publisher Website
Google Scholar
Abstract
At Metropolitan Hospital Center, New York City, USA, 3000 patients with trauma were admitted during 1974-1978, with a mortality rate of 4%; 108 patients who were admitted and died were analyzed. Ages ranged 3 mo.-84 yr with clusters at 15-30 and 45-60 yr. Injury Severity Scores (ISS) ranged from 9-66 (average, 37). All body systems were equally represented. Most patients had 2 systems involved. Abbreviated Injury Scale (AIS) scores for most severe systems were 5 in 60%, 4 in 34% and 3 in 6%. Shock was present in 52%. Major complications: sepsis in 30% (pulmonary, 20%); neurological, 12%; respiratory failure 15%; renal failure 10%. Surgical care was optimal in 45%. In the remaining 55% at least 1 error occurred: inappropriate or inadequate fluid resuscitation, 37%; missed or delayed diagnosis, 20%; airway management, 10%; surgical judgment, 8%; surgical techniques, 9%. ISS scores showed no significant differences between the error/no error shock/no shock groups. Patients with AIS scores of 3 were elderly or had errors in management. Management errors continue to be made in a significant number of severely injured patients, and may contribute to the demise of patients with survivable injury.

This publication has 0 references indexed in Scilit: