Data on all deaths after injuries in Lothian and Borders regions of so
uth-east Scotland were collected prospectively over 2 years. Post-mort
ems were performed after all deaths and Injury Severity Scores (ISS) c
alculated. There were 331 deaths ata rate of 20 per 100 000 per year;
of those who died 49 per cent were younger than 40 years and most were
male; 37 per cent of deaths were caused by road traffic accidents, 16
per cent by falls and 15 per cent by hangings. Two hundred and forty-
eight patients (75 per cent) were either dead when found or died insta
ntly with unsurvivable injuries (ISS = 75). A further five patients di
ed in the first hour after injury and before reaching hospital. Ninete
en (7 per cent) died between 3 and 4 h after injury, 59 (17 per cent)
died move than 4 h after. These results demonstrate the rate, causes a
nd timing of deaths following injuries in one UK region. The pattern o
f these deaths differs markedly from that previously described in the
US. There is no evidence to support the concept of a trimodal distribu
tion of trauma deaths. The greatest potential to reduce the number of
trauma deaths lies with prevention. (C) 1996 Published by Elsevier Sci
ence Ltd.