외상후 사망한 환자의 임상적 분석 = Clinical Analysis of Post - traumatic Deaths

다국어 초록 (Multilingual Abstract)

Trauma is a leading cause of death in Korea, but trauma care system are not well developed. To characterize cause of death and unexpected death following trauma, 295 traumatic deaths from January, 1987 to December, 1994 at Kangnam Sacred Heart Hospital were retrospectively reviewed for mechanism of injury, trauma indices, cause of death, and preventability. Of the 295 traumatic deaths, 119 patients(40%) died in the emergency room (ER) and 176 patients(60%) died in operating room or intensive care unit (ICU). Male-to-female ratio was 2.2:1 and the mean age was 36 + 20 years (range, 1-86 years). The mean time between the injury and initial treatment in ER was 227 + 888 minutes (441 + 1295 minutes for prehospital care group vs. 86+393 minutes for non- prehospital care group), but there was no significant difference hetween prehospital care group and non-prehospital care group in trauma indices. There were 209(70.8%) motor vehicle crashes, 51(17.4%) fall downs, 16(5.4%) violences, 16(5.4%) stab wounds, and 3(1. 0%) other injuries. Brain injury was judged to be the main cause of death in 51. 5% of patients. The causes of 20 unexpected deaths in ICU inspite of Ps>0.5 via TRISS methodology were hypovolemic shock(40.0%) and brain injury(25.0%). The APACHE II system significantly overestimated the risk of cleath in the lower ranges of predicted risk and underestimated the deaths in the higher ranges. Although TRISS methodology was not developed for ICU trauma patients, it tended to perform better than APACHE II system in our sample.