Lethal outcome and time to death in injured hospitalised patients
AbstractObjectives: There is a recent realization tha tdeath following injury is time dependent and occurs in a predictable way. The object of this study therefore is to identify trauma death pattern in our environment with emphasis on time of death with the view to proffer efficient trauma care strategies.
Methods: The medical records of patients admitted acutely through the Accident and Emergency Department of our institution and who subsequently died between 1998 and 2000 were reviewed. Such information as their age, sex, aetiology of injury, primary diagnosis on admission, interval between injury and presentation, and time to death, and the cause of death as recorded in the duplicate copy of death certificates were collected and analyzed.
Results: There were 85 trauma related deaths, fifty-one males and thirty-four females. The male to female ratio is 1.5:1. The age range is 6-78 years with a mean of 36-/+2.5 years. The most common aetiological factor was road traffic accidents 43(50.59%). This was followed by burns35 (41.17%). Of the 85 patients, burns were the most common diagnoses on admission 46 (54.12%). Fifteen (17.65%) cases sustained injuries to multiple organ systems injuries while open fractures accounted for 12(14.12%) of the deaths. The time to death showed two peaks. The first peak accounted for 12(14.12%) of the deaths. The time to death showed two peaks occurred within the first 96 hours du to uncompensated shock, respiratory failure and acute renalshot down while the second peak was observed after the twelfth day due to sepsis and multiple organ failure.
Conclusion: Trauma is common cause of death. In our setting patients that arrived the hospital alive run the risk of of dying from complications ranging from uncompensated shock in the immediate post injury period to multiple organ failure later. These deaths are largely preventable if a well-funded comprehensive trauma system manned by skilled personnel is put in place.
Keywords: Lethal outcome, time to death, injured hospitalized patients
Orient Journal of Medicine Vol. 17 (1&2) 2005: 28-33