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Trauma-related Preventable Deaths in Berlin 2010: Need to Change Prehospital Management Strategies and Trauma Management Education

Kleber, C. ; Giesecke, M. T. ; Tsokos, M. ; Haas, N. P. ; Buschmann, C. T.

World journal of surgery, 2013-05, Vol.37 (5), p.1154-1161 [Periódico revisado por pares]

New York: Springer-Verlag

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Título:
Trauma-related Preventable Deaths in Berlin 2010: Need to Change Prehospital Management Strategies and Trauma Management Education
Autor: Kleber, C. ; Giesecke, M. T. ; Tsokos, M. ; Haas, N. P. ; Buschmann, C. T.
Assuntos: Abdominal Surgery ; Adult ; Aged ; Berlin - epidemiology ; Cardiac Surgery ; Cause of Death ; Emergency Medical Services - methods ; Emergency Medical Services - organization & administration ; Emergency Medical Services - statistics & numerical data ; Emergency Physician ; Emergency Treatment - mortality ; Emergency Treatment - standards ; Emergency Treatment - statistics & numerical data ; Female ; General Surgery ; Helicopter Emergency Medical Service ; Hospital Mortality ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Prehospital Setting ; Preventable Death ; Preventive Health Services ; Prospective Studies ; Surgery ; Thoracic Surgery ; Traumatic Death ; Traumatology - education ; Vascular Surgery ; Wounds and Injuries - mortality ; Wounds and Injuries - therapy
É parte de: World journal of surgery, 2013-05, Vol.37 (5), p.1154-1161
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: Background Fatal trauma is one of the leading causes of death in Western industrialized countries. The aim of the present study was to determine the preventability of traumatic deaths, analyze the medical measures related to preventable deaths, detect management failures, and reveal specific injury patterns in order to avoid traumatic deaths in Berlin. Materials and methods In this prospective observational study all autopsied, direct trauma fatalities in Berlin in 2010 were included with systematic data acquisition, including police files, medical records, death certificates, and autopsy records. An interdisciplinary expert board judged the preventability of traumatic death according to the classification of non-preventable (NP), potentially preventable (PP), and definitively preventable (DP) fatalities. Results Of the fatalities recorded, 84.9 % ( n = 224) were classified as NP, 9.8 % ( n = 26) as PP, and 5.3 % ( n = 14) as DP. The incidence of severe traumatic brain injury (sTBI) was significantly lower in PP/DP than in NP, and the incidence of fatal exsanguinations was significantly higher. Most PP and NP deaths occurred in the prehospital setting. Notably, no PP or DP was recorded for fatalities treated by a HEMS crew. Causes of DP deaths consisted of tension pneumothorax, unrecognized trauma, exsanguinations, asphyxia, and occult bleeding with a false negative computed tomography scan. Conclusions The trauma mortality in Berlin, compared to worldwide published data, is low. Nevertheless, 15.2 % ( n = 40) of traumatic deaths were classified as preventable. Compulsory training in trauma management might further reduce trauma-related mortality. The main focus should remain on prevention programs, as the majority of the fatalities occurred as a result of non-survivable injuries.
Editor: New York: Springer-Verlag
Idioma: Inglês

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Trauma-related Preventable Deaths in Berlin 2010: Need to Change Prehospital Management Strategies and Trauma Management Education

Kleber, C. ; Giesecke, M. T. ; Tsokos, M. ; Haas, N. P. ; Buschmann, C. T.

New York: Springer-Verlag

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