Abstract

Background
Trauma-induced deaths can be prevented by implementation of trauma system during prehospital phases and in-hospital phases. To reduce the preventable death rate (PDR), it is essential to improve the treatment strategy during the prehospital phases and the in-hospital phases. This study was designed to compares the prehospital death and emergency department (ED) death in a city before and after implementation of trauma system. Method: We evaluated the prehospital and ED data of 106 trauma patients who had died in 1991 and 2001. Trauma deaths were reviewed and the preventability of those deaths was judged by three professional panels according to appropriateness of diagnosis and treatment in prehospital phases and in-hospital phases. Deaths were classified as preventable and nonpreventable. We compared the preventable death of 1991 with those of 2001. Result: Trauma patients were 993 in 1991 and 3,094 in 2001. Trauma-induced deaths were 60 in 1991 and 46 in 2001. The death rate decreased from 6% in 1991 to 1.5% in 2001 (p<0.001). Death rate by traffic accident decreased from 90% (54/60) in 1991 to 67% (31/46) in 2001 (p<0.001). The PDR decreased from 40% (24/60) in 1991 to 13% (6/46) in 2001 (p<0.001). The time elapsed from the scene of accident to ED arrival decreased from 111 minutes in 1991 to 53 minutes in 2001 (p<0.001). There was no significant difference in Injury Severity Score between Conclusion: The rate of preventable death decreased from 1991 to 2001. Implementation and improvement of the trauma system has positive effects on trauma-induced death rate, PDR and the time elapsed from the scene of accident to ED arrival.

• Keywords: Trauma system, Preventable death, Emergency department