Abstract
Abstract
Background
Trauma related deaths remain a relevant public health problem, in particular in the younger male population. A significant number of these deaths occur prehospitally without transfer to a hospital. These patients, sometimes termed “the forgotten cohort”, are usually not included in clinical registries, resulting in a lack of information about prehospitally trauma deaths. The aim of the present study was to compare patients who died prehospital with those who sustained life-threatening injuries in order to analyze and potentially improve prehospital strategies.
Methods
This cohort study included all primary operations carried out by Switzerland's largest helicopter emergency medical service (HEMS) between January 1, 2011, and December 31, 2021. We included all adult trauma patients with life-threatening or fatal conditions. The outcome of this study is the vital status of the patient at the end of mission, i.e. fatal or life-threatening. Injury, rescue characteristics, and interventions of the forgotten trauma cohort, defined as patients with a fatal injury (NACA score of VII), were compared with life-threatening injuries (NACA score V and VI).
Results
Of 110,331 HEMS missions, 5534 primary operations were finally analyzed, including 5191 (93.8%) life-threatening and 343 (6.2%) fatal injuries. More than two-thirds of patients (n = 3772, 68.2%) had a traumatic brain injury without a significant difference between the two groups (p > 0.05). Thoracic trauma (44.6% vs. 28.7%, p < 0.001) and abdominal trauma (22.2% vs. 16.1%, p = 0.004) were more frequent in fatal missions whereas pelvic trauma was similar between the two groups (13.4% vs. 12.9%, p = 0.788). Pneumothorax decompression rate (17.2% vs. 3.7%, p < 0.001) was higher in the forgotten cohort group and measures for bleeding control (15.2% vs. 42.7%, p < 0.001) and pelvic belt application (2.9% vs. 13.1% p < 0.001) were more common in the life-threating injury group.
Conclusion
Chest decompression rates and measures for early hemorrhage control are areas for potential improvement in prehospital care.
Publisher
Springer Science and Business Media LLC
Subject
Critical Care and Intensive Care Medicine,Emergency Medicine
Reference82 articles.
1. Haagsma JA, Graetz N, Bolliger I, Naghavi M, Higashi H, Mullany EC, et al. The global burden of injury: Incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev. 2016;22(1):3–18.
2. World Health Organization. Preventing injuries and violence: an overview Geneva2022 [cited 2023 19.04.]. Available from: https://apps.who.int/iris/bitstream/handle/10665/361331/9789240047136-eng.pdf?sequence=1&isAllowed=y.
3. World Health Organization. Global Health Estimates: Life expectancy and leading causes of death and disability Geneva: World Health Organization; no Date [cited 2023 18.04]. Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates.
4. Pfeifer R, Tarkin IS, Rocos B, Pape HC. Patterns of mortality and causes of death in polytrauma patients—has anything changed? Injury. 2009;40(9):907–11.
5. Rossiter ND. Trauma-the forgotten pandemic? Int Orthop. 2022;46(1):3–11.
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