PREVENTABLE DEATHS AMONG MAJOR TRAUMA PATIENTS IN MERSEY REGION, NORTH WALES AND THE ISLE-OF-MAN

Preventable and unexpected deaths following injury were identified fro m among 1088 victims of major injuries arising in a defined population and area during a 12-month period. In hospital, 44(16 per cent) death s from blunt injury, one death from penetrating injury and one death f rom drowning were preventable. In patients sustaining blunt injuries, 22 per cent of non-head-injury deaths and 13 per cent of head-injury d eaths were preventable. In all preventable head-injury deaths either a delay in operation (35 per cent) or no operation for mass lesions (65 per cent) occurred, often because of misdiagnosis as alcohol intoxica tion (22 per cent) or CVA (22 per cent). Multiple preventable factors were more likely in non-head-injury deaths and included missed injurie s (67 per cent), poor airway care (57 per cent), delayed or no operati on (52 per cent), undertransfusion (38 per rent) and inadequate surger y (19 per cent). By TRISS methodology the outcome was unexpected, in 5 3 per cent blunt injury deaths in hospital and 2.8 per cent of survivo rs. Three preventable blunt injury deaths (6.8 per cent) had probabili ties of survival < 50 per rent and were not, therefore, identified as unexpected by TRISS. A preventable death rate of 16 per cent for blunt injuries equates to 638 preventable blunt injury deaths each year in England and Wales. Copyright (C) 1996 Elsevier Science Ltd.