FATAL TRAUMA - THE MODAL DISTRIBUTION OF TIME TO DEATH IS A FUNCTION OF PATIENT DEMOGRAPHICS AND REGIONAL RESOURCES

Background: Unlike previous studies in an urban environment, this stud y examines traumatic death in a geographically diverse county in the s outhwestern United States. Methods: All deaths from blunt and penetrat ing trauma between November 15, 1991, and November 14, 1993, were incl uded, As many as 150 variables were collected on each patient, includi ng time of injury and time of death. Initial identification of cases w as through manual review of death records. Information was supplemente d by review of hospital records, case reports, and prehospital encount er forms. Results: A total of 710 traumatic deaths were analyzed. Appr oximately half of the victims, 52%, were pronounced dead at the scene. Of the 48% who were hospitalized, the most frequent mechanism of inju ry was a fall. Neurologic dysfunction was the most common cause of dea th. Two distinct peaks of time were found on analysis: 23% of patients died within the first 60 minutes, and 35% of patients died at 24 to 4 8 hours after injury. Conclusions: Although there appears to continue to be a trimodal distribution of trauma deaths in urban environments, we found the distribution to be bimodal in an environment with a highe r ratio of blunt to penetrating trauma.