Browse > Article
http://dx.doi.org/10.20408/jti.2020.0074

Major Causes of Preventable Death in Trauma Patients  

Park, Youngeun (Department of Traumatology, Gachon University Gil Medical Center)
Lee, Gil Jae (Department of Traumatology, Gachon University Gil Medical Center)
Lee, Min A (Department of Traumatology, Gachon University Gil Medical Center)
Choi, Kang Kook (Department of Traumatology, Gachon University Gil Medical Center)
Gwak, Jihun (Department of Traumatology, Gachon University Gil Medical Center)
Hyun, Sung Youl (Department of Traumatology, Gachon University Gil Medical Center)
Jeon, Yang Bin (Department of Traumatology, Gachon University Gil Medical Center)
Yoon, Yong-Cheol (Department of Traumatology, Gachon University Gil Medical Center)
Lee, Jungnam (Department of Traumatology, Gachon University Gil Medical Center)
Yu, Byungchul (Department of Traumatology, Gachon University Gil Medical Center)
Publication Information
Journal of Trauma and Injury / v.34, no.4, 2021 , pp. 225-232 More about this Journal
Abstract
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.
Keywords
Regional trauma center; Severe trauma; Preventable death rate;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Ghorbani P, Strommer L. Analysis of preventable deaths and errors in trauma care in a Scandinavian trauma level-I centre. Acta Anaesthesiol Scand 2018;62:1146-53.   DOI
2 Esposito TJ, Sanddal TL, Reynolds SA, Sanddal ND. Effect of a voluntary trauma system on preventable death and inappropriate care in a rural state. J Trauma 2003;54:663-70.   DOI
3 Boyd CR, Tolson MA, Copes WS. Evaluating trauma care: the TRISS method. Trauma Score and the Injury Severity Score. J Trauma 1987;27:370-8.   DOI
4 Kim Y, Jung KY, Cho KH, Kim H, Ahn HC, Oh SH, et al. Preventable trauma deaths rates and management errors in emergency medical system in Korea. J Korean Med Sci 2006;17:385-94.
5 West JG. Validation of autopsy method for evaluating trauma care. Arch Surg 1982;117:1033-5.   DOI
6 Jung KY, Kim SP, Kin SH, Kim H, Noh H, Chang HY, et al. A study on emergency medical system performance indicators in Korea [Internet]. Sejong: Ministry of Health and Welfare 2008 [cited 2020 Sep 10]. Available from: https://webcache.googleusercontent.com/search?q=cache:4cqokX7gwdsJ:https://media.nemc.or.kr/file/download_file_encrypt.do%3Ffileitemno%3Dcb7aa0cf2fdcc380dde65cbe65334cab+&cd=1&hl=ko&ct=-clnk&gl=kr.
7 Pfeifer R, Lichte P, Zelle BA, Sittaro NA, Zilkens A, Kaneshige JR, et al. Socio-economic outcome after blunt orthopaedic trauma: implications on injury prevention. Patient Saf Surg 2011;5:9.   DOI
8 Statistics Korea. Causes of death statistics in 2016 [Internet]. Daejeon: Statistics Korea 2017 [cited 2020 Sep 10]. Available from: http://kostat.go.kr/portal/eng/pressReleases/1/index.board?bmode=read&bSeq=&aSeq=363695&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=srch&sTarget=title&sTxt=death+.
9 Corso P, Finkelstein E, Miller T, Fiebelkorn I, Zaloshnja E. Incidence and lifetime costs of injuries in the United States. Inj Prev 2015;21:434-40.   DOI
10 Brenneman FD, Redelmeier DA, Boulanger BR, McLellan BA, Culhane JP. Long-term outcomes in blunt trauma: who goes back to work?. J Trauma 1997;42:778-81.   DOI
11 Chiara O, Cimbanassi S, Pitidis A, Vesconi S. Preventable trauma deaths: from panel review to population based-studies. World J Emerg Surg 2006;1:12.   DOI
12 Jung K, Kim I, Park SK, Cho H, Park CY, Yun JH, et al. Preventable trauma death rate after establishing a national trauma system in Korea. J Korean Med Sci 2019;34:e65.   DOI
13 Hartl R, Gerber LM, Iacono L, Ni Q, Lyons K, Ghajar J. Direct transport within an organized state trauma system reduces mortality in patients with severe traumatic brain injury. J Trauma 2006;60:1250-6.   DOI
14 Jung KY, Kim SP, Kin SH, Kim H, Noh H, Chang HY, et al. Analysis and development plan of South Korea's trauma medical system [Internet]. Sejong: Ministry of Health and Welfare 2011 [cited 2020 Sep 10]. Available from: https://webcache.googleusercontent.com/search?q=cache:RTuwoTRf5OEJ:https://media.nemc.or.kr/file/download_file_encrypt.do%3Ffileitemno%3D-6c1efcf9f8fb4033b1cb51a8367612b4+&cd=2&hl=ko&ct=-clnk&gl=kr.
15 Zafarghandi MR, Modaghegh MH, Roudsari BS. Preventable trauma death in Tehran: an estimate of trauma care quality in teaching hospitals. J Trauma 2003;55:459-65.   DOI
16 Teixeira PG, Inaba K, Hadjizacharia P, Brown C, Salim A, Rhee P, et al. Preventable or potentially preventable mortality at a mature trauma center. J Trauma 2007;63:1338-47.   DOI
17 Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974;14:187-96.   DOI
18 Cayten CG, Stahl WM, Agarwal N, Murphy JG. Analyses of preventable deaths by mechanism of injury among 13,500 trauma admissions. Ann Surg 1991;214:510-21.   DOI
19 MacKenzie EJ. Review of evidence regarding trauma system effectiveness resulting from panel studies. J Trauma 1999;47(Suppl 3):S34-41.   DOI
20 Oyeniyi BT, Fox EE, Scerbo M, Tomasek JS, Wade CE, Holcomb JB. Trends in 1029 trauma deaths at a level 1 trauma center: impact of a bleeding control bundle of care. Injury 2017;48:5-12.   DOI