둔상에 의한 다발성 외상환자의 사망 원인과 병원 내 사망률의 패턴 분석

Abstract

Purpose: This study evaluates patterns of in-hospital mortality and causes of death in blunt poly-trauma patients.Methods: Data of blunt poly-trauma patients admitted between 2011 and 2013 were retrospectively collected and analyzed. Poly-trauma was defined as an Injury Severity Score (ISS) was greater than 15. The following variables were extracted and analyzed: age, sex, ISS, Revised Trauma Score (RTS), injury mechanism, cause of death, and patterns in-hospital mortality rate. Results: Two hundred and ten patients with blunt poly-trauma were admitted. Injuries occurred predominately in the age group of 45∼64 years. Injuries occurred predominantly in males (70%). Traffic accidents (67.6%) and falls (30.5%) were the main causes of trauma. Forty-six patients (21.9%) died in the study sample. Six patients (13%) died within one hour, 23 (23.9%) between one and four hours after arrival to emergency room, six (6.5%) died during the first two weeks of hospitalization, and six (6.5%) died in the fourth week of hospitalization. The median ISS of those who died was 39.5 (20.5∼70.5) and median RTS was 4.01 (1.85∼6.15). The major cause of early death was exsanguination (39.1%), followed by central nervous system injury (34.8%). Sepsis or multi-organ failure (26.1%) were the predominant causes of late death. Conclusion: The in-hospital mortality rate is similar to other studies. However, cause of death and injury mechanisms of blunt poly-trauma death are somewhat different from other countries. Recognition of these injury and mortality patterns will help improve the trauma system.