Journal of Trauma and Injury

Original Articles

Major Causes of Preventable Death in Trauma Patients: Youngeun Park, Gil Jae Lee, Min A Lee, Kang Kook Choi, Jihun Gwak, Sung Youl Hyun, Yang Bin Jeon, Yong-Cheol Yoon, Jungnam Lee, Byungchul Yu; J Trauma Inj. 2021;34(4):225-232. Published online July 29, 2021; DOI: https://doi.org/10.20408/jti.2020.0074

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Purpose

Trauma is the top cause of death in people under 45 years of age. Deaths from severe trauma can have a negative economic impact due to the loss of people belonging to socio-economically active age groups. Therefore, efforts to reduce the mortality rate of trauma patients are essential. The purpose of this study was to investigate preventable mortality in trauma patients and to identify factors and healthcare-related challenges affecting mortality. Ultimately, these findings will help to improve the quality of trauma care.

Methods

We analyzed the deaths of 411 severe trauma patients who presented to Gachon University Gil Hospital regional trauma center in South Korea from January 2015 to December 2017, using an expert panel review.

Results

The preventable death rate of trauma patients treated at the Gachon University Gil Hospital regional trauma center was 8.0%. Of these, definitely preventable deaths comprised 0.5% and potentially preventable deaths 7.5%. The leading cause of death in trauma patients was traumatic brain injury. Treatment errors most commonly occurred in the intensive care unit (ICU). The most frequent management error was delayed treatment of bleeding.

Conclusions

Most errors in the treatment of trauma patients occurred in early stages of the treatment process and in the ICU. By identifying the main causes of preventable death and errors during the course of treatment, our research will help to reduce the preventable death rate. Appropriate trauma care systems and ongoing education are also needed to reduce preventable deaths from trauma.

Summary

Citations

Citations to this article as recorded by

Effects of Transport to Trauma Centers on Survival Outcomes Among Severe Trauma Patients in Korea: Nationwide Age-Stratified Analysis
Hakrim Kim, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Tae Han Kim, Stephen Gyung Won Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
TiME OUT: Time-specific machine-learning evaluation to optimize ultramassive transfusion
Courtney H. Meyer, Jonathan Nguyen, Andrew ElHabr, Nethra Venkatayogi, Tyler Steed, Judy Gichoya, Jason D. Sciarretta, James Sikora, Christopher Dente, John Lyons, Craig M. Coopersmith, Crystal Nguyen, Randi N. Smith
Journal of Trauma and Acute Care Surgery.2024; 96(3): 443. CrossRef
Progressive Reduction in Preventable Mortality in a State Trauma System Using Continuous Preventable Mortality Review to Drive Provider Education: Results of Analyzing 1,979 Trauma Deaths from 2015 to 2022
Charles D Mabry, Benjamin Davis, Michael Sutherland, Ronald Robertson, Jennifer Carger, Deidre Wyrick, Terry Collins, Austin Porter, Kyle Kalkwarf
Journal of the American College of Surgeons.2024; 238(4): 426. CrossRef
Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea
Yu Jin Lee, Soon Tak Jeong, Joongsuck Kim, Kwanghee Yeo, Ohsang Kwon, Kyounghwan Kim, Sung Jin Park, Jihun Gwak, Wu Seong Kang
Journal of Trauma and Injury.2024; 37(1): 20. CrossRef
Angioembolization performed by trauma surgeons for trauma patients: is it feasible in Korea? A retrospective study
Soonseong Kwon, Kyounghwan Kim, Soon Tak Jeong, Joongsuck Kim, Kwanghee Yeo, Ohsang Kwon, Sung Jin Park, Jihun Gwak, Wu Seong Kang
Journal of Trauma and Injury.2024; 37(1): 28. CrossRef
Nomogram for predicting in-hospital mortality in trauma patients undergoing resuscitative endovascular balloon occlusion of the aorta: a retrospective multicenter study
Byungchul Yu, Jayun Cho, Byung Hee Kang, Kyounghwan Kim, Dong Hun Kim, Sung Wook Chang, Pil Young Jung, Yoonjung Heo, Wu Seong Kang
Scientific Reports.2024;[Epub] CrossRef
Preventable trauma deaths in the Western Cape of South Africa: A consensus-based panel review
Julia Dixon, Shaheem de Vries, Chelsie Fleischer, Smitha Bhaumik, Chelsea Dymond, Austin Jones, Madeline Ross, Julia Finn, Heike Geduld, Elmin Steyn, Hendrick Lategan, Lesley Hodsdon, Janette Verster, Suzan Mukonkole, Karlien Doubell, Navneet Baidwan, Nee
PLOS Global Public Health.2024; 4(5): e0003122. CrossRef
Prolonged time to recovery and its predictors among trauma patients admitted to the intensive care units in comprehensive specialized hospitals in Northwest Ethiopia: a multicenter retrospective follow-up study, 2022
Mengistu Abebe Messelu, Temesgen Ayenew, Tesfa Sewunet Alamneh, Tiruye Azene Demile, Aster Tadesse Shibabaw, Asnake Gashaw Belayneh
Frontiers in Medicine.2024;[Epub] CrossRef
The characteristics and clinical outcomes of trauma patients transferred by a physician-staffed helicopter emergency medical service in Korea: a retrospective study
Myung Jin Jang, Woo Sung Choi, Jung Nam Lee, Won Bin Park
Journal of Trauma and Injury.2024; 37(2): 106. CrossRef
Evaluation of Current and Future Medical Staff Knowledge on the Course of Trauma Patient Management
Anna Dąbrowska, Wiktoria Malik, Dorota Czachor, Weronika Jarych, Anna Wściślak, Zuzanna Świąder, Łucja Komisarczyk, Piotr Pałczyński
Cureus.2024;[Epub] CrossRef
A Deployable Viscoelastic Coagulation Monitor Enables Point-of-Care Assessment of Coagulopathy in Swine With Polytrauma
Teryn R Roberts, Isabella Garcia, Ivan Slychko, Heidi J Dalton, Andriy I Batchinsky
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Analysis of mortality over 7 years in a mature trauma center: evolution of preventable mortality in severe trauma patients
Sarah Guigues, Jean Cotte, Jean-Baptiste Morvan, Henry de Lesquen, Bertrand Prunet, Mathieu Boutonnet, Nicolas Libert, Pierre Pasquier, Eric Meaudre, Julien Bordes, Michael Cardinale
European Journal of Trauma and Emergency Surgery.2023; 49(3): 1425. CrossRef
Incidence and predictors of mortality among adult trauma patients admitted to the intensive care units of comprehensive specialized hospitals in Northwest Ethiopia
Mengistu Abebe Messelu, Ambaye Dejen Tilahun, Zerko Wako Beko, Hussien Endris, Asnake Gashaw Belayneh, Getayeneh Antehunegn Tesema
European Journal of Medical Research.2023;[Epub] CrossRef
Characteristics and Clinical Outcomes of Elderly Patients with Trauma Treated in a Local Trauma Center
Kwanhoon Park, Geonjae Cho, Sungho Lee, Kang Yoon Lee, Ji Young Jang
Journal of Acute Care Surgery.2023; 13(1): 13. CrossRef
An Artificial Intelligence Model for Predicting Trauma Mortality Among Emergency Department Patients in South Korea: Retrospective Cohort Study
Seungseok Lee, Wu Seong Kang, Do Wan Kim, Sang Hyun Seo, Joongsuck Kim, Soon Tak Jeong, Dong Keon Yon, Jinseok Lee
Journal of Medical Internet Research.2023; 25: e49283. CrossRef
Preventable Death Rate of Trauma Patients in a Non-Regional Trauma Center
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Journal of Acute Care Surgery.2023; 13(3): 118. CrossRef
Nine year in-hospital mortality trends in a high-flow level one trauma center in Italy
Elisa Reitano, Roberto Bini, Margherita Difino, Osvaldo Chiara, Stefania Cimbanassi
Updates in Surgery.2022; 74(4): 1445. CrossRef
Decision support by machine learning systems for acute management of severely injured patients: A systematic review
David Baur, Tobias Gehlen, Julian Scherer, David Alexander Back, Serafeim Tsitsilonis, Koroush Kabir, Georg Osterhoff
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Flat Inferior Vena Cava on Computed Tomography for Predicting Shock and Mortality in Trauma: A Meta-Analysis
Do Wan Kim, Hee Seon Yoo, Wu Seong Kang
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Model for Predicting In-Hospital Mortality of Physical Trauma Patients Using Artificial Intelligence Techniques: Nationwide Population-Based Study in Korea
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Thoracic injuries in trauma patients: epidemiology and its influence on mortality
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Scandinavian Journal of Trauma, Resuscitation and .2022;[Epub] CrossRef

A Comparison of the Effectiveness of Before and After the Regional Trauma Center's Establishment: Bo Hyung Song, Sung Youl Hyun, Jin Joo Kim, Jin Seong Cho, Dae Sung Ma, Ha Kyung Kim, Geun Lee; J Trauma Inj. 2016;29(3):68-75. Published online September 30, 2016; DOI: https://doi.org/10.20408/jti.2016.29.3.68

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Abstract PDF

PURPOSE
The purpose of this study was to analyze the effectiveness of regional trauma center's management.
METHODS
Data collected between January 2013 and December 2015 from a regional trauma center registry was retrospectively reviewed. The patients who had injury severity score (ISS) greater than 15 and over the age of 18 were included. We compared annual general characteristics, the injury mechanism, the pathway of transportation, the injury severity score, the length of stay in emergency department (ED) and hospital, the in-hospital mortality.
RESULTS
The annual numbers of enrolled patients were 337, 334 and 278, respectively. No significant differences were found in the annual patient's median ages, injury mechanism, ISS and in-hospital mortality. The annual proportions of coming from other hospital and the median length of stay in hospital were increased after establishment of regional trauma center. The annual median lengths of stay in ED were decreased remarkably.
CONCLUSION
Through the establishment of regional trauma center, the length of stay in ED can be reduced but not in-hospital mortality. More multidisciplinary cooperation and well-organized study is needed to reduce mortality of major trauma patients and maximize effect of regional trauma center.

Summary

Citations

Citations to this article as recorded by

The Effects of a Trauma Team Approach on the Management of Open Extremity Fractures in Polytrauma Patients: A Retrospective Comparative Study
Seungyeob Sakong, Eic Ju Lim, Jun-Min Cho, Nak-Jun Choi, Jae-Woo Cho, Jong-Keon Oh
Journal of Trauma and Injury.2021; 34(2): 105. CrossRef

Three-year Analysis of Patients and Treatment Experiences in the Regional Trauma Center of Gachon University Gil Hospital between 2011 and 2013: Yong Cheol Yoon, Jung Nam Lee, Min Chung, Yang Bin Jeon, Jae Jeong Park, Byung Chul Yu, Gil Jae Lee, Hyun Jin Cho, Dae Sung Ma, Min A Lee, Jung Ju Choi, Seong Son; J Trauma Inj. 2014;27(4):170-177.

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Abstract PDF: PURPOSE
The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center.
METHODS
The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013.
RESULTS
The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of > or =16. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital.
CONCLUSION
A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.; Summary

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