Citation

Gewiess J, Albers CE, Pape HC, Bangerter H, Zech WD, Keel MJB, Bastian JD. J. Clin. Med. 2021; 10(20).

Copyright

(Copyright © 2021, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/jcm10204765

PMID

unavailable

Abstract

BACKGROUND: Using Injury Severity Score (ISS) data, this study aimed to give an overview of trauma mechanisms, causes of death, injury patterns, and potential survivability in prehospital trauma victims.

METHODS: Age, gender, trauma mechanism, cause of death, and ISS data were recorded regarding forensic autopsies and whole-body postmortem CT. Characteristics were analyzed for injuries considered potentially survivable at cutoffs of (I) ISS ≤ 75 vs. ISS = 75, (II) ISS ≤ 49 vs. ISS ≥ 50, and (III) ISS < lethal dose 50% (LD50) vs. ISS > LD50 according to Bull's probit model.

RESULTS: In n = 130 prehospital trauma victims (45.3 ± 19.5 years), median ISS was 66. Severity of injuries to the head/neck and chest was greater compared to other regions (p < 0.001). 52% died from central nervous system (CNS) injury. Increasing injury severity in head/neck region was associated with CNS-injury related death (odds ratio (OR) 2.7, confidence interval (CI) 1.8-4.4). Potentially survivable trauma was identified in (I) 56%, (II) 22%, and (III) 9%. Victims with ISS ≤ 75, ISS ≤ 49, and ISS < LD50 had lower injury severity across most ISS body regions compared to their respective counterparts (p < 0.05).

CONCLUSION: In prehospital trauma victims, injury severity is high. Lethal injuries predominate in the head/neck and chest regions and are associated with CNS-related death. The appreciable amount (9-56%) of victims dying at presumably survivable injury severity encourages perpetual efforts for improvement in the rescue of highly traumatized patients. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Language: en

Keywords

adult; human; suicide; burn; female; male; injury; hypothermia; aged; autopsy; head injury; injury severity; cause of death; death; major clinical study; controlled study; victim; disease association; middle aged; laceration; computer assisted tomography; head and neck injury; thorax injury; multiple trauma; face injury; abdominal injury; injury scale; Polytrauma; abrasion; Article; accidental injury; electric injury; limb injury; body regions; clinical evaluation; very elderly; LD50; criminalistics; Injury Severity Score (ISS); postmortem computed tomography; Prehospital death; Trauma victims