Abstract
INTRODUCTION: The information about the long-term mortality and causes of death after multiple injuries is sparse. In general, most follow-up studies report on 1 year to 3 years maximum follow up. The current literature focuses on causes of death immediately after trauma or during the initial in-hospital stay. We report on long-term mortality and causes of death in patients with multiple injures up to 30 years after the initial injury. METHODS AND MATERIAL: We analyzed the causes of death using patient files, inquiries of patients' relatives, and death certificates. Inclusion criteria are (1) polytrauma (PT) (Injury Severity Score ≥16) between 1973 and 1990; (2) age 3 years to 60 years at injury; (3) admission to the hospital alive; and (4) death during the study period. Patients were separated into two groups: patients deceased during the initial hospital stay (in-hospital deaths, n = 408) and patients deceased after discharge (postdischarge deaths, n = 103). The survival of the PT victims was compared descriptively with age- and gender-matched data from the general population (GP). RESULTS: Causes of death in in-hospital deaths are head injury (37%), adult respiratory distress syndrome (14%), sepsis (11%), hemorrhagic shock (10%), pneumonia (9%), multiple organ failure (9%), and others (10%). Causes of death after discharge included cardiovascular diseases (23%), second major trauma (19%), neurologic diseases (16%), suicide (10%), malignancies (6%), and others (26%). The analysis of survival showed a higher mortality for PT compared with the GP group during the first year after the event (p < 0.05). Between 2 years and 10 years after the event, the annual mortality of the PT-group approximates the GP group. CONCLUSION: PT patients who die after discharge from the initial hospitalization show other causes of death than age-matched controls of the general population. Among these are second major trauma and suicide. Future studies should investigate whether certain social or psychologic factors might play a role.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1212-1217 |
| Number of pages | 6 |
| Journal | Journal of Trauma - Injury, Infection and Critical Care |
| Volume | 66 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2009 |
| Externally published | Yes |
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Keywords
- Cause of death
- Mortality
- Multiple injuries
- Outcome
- Polytrauma
- Survival
ASJC Scopus subject areas
- Surgery
- Critical Care and Intensive Care Medicine
Cite this
Late death after multiple severe trauma : When does it occur and what are the causes? / Probst, Christian; Zelle, Boris A; Sittaro, Nicola A.; Lohse, Ralf; Krettek, Christian; Pape, Hans C.
In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 66, No. 4, 04.2009, p. 1212-1217.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Late death after multiple severe trauma
T2 - When does it occur and what are the causes?
AU - Probst, Christian
AU - Zelle, Boris A
AU - Sittaro, Nicola A.
AU - Lohse, Ralf
AU - Krettek, Christian
AU - Pape, Hans C.
PY - 2009/4
Y1 - 2009/4
N2 - INTRODUCTION: The information about the long-term mortality and causes of death after multiple injuries is sparse. In general, most follow-up studies report on 1 year to 3 years maximum follow up. The current literature focuses on causes of death immediately after trauma or during the initial in-hospital stay. We report on long-term mortality and causes of death in patients with multiple injures up to 30 years after the initial injury. METHODS AND MATERIAL: We analyzed the causes of death using patient files, inquiries of patients' relatives, and death certificates. Inclusion criteria are (1) polytrauma (PT) (Injury Severity Score ≥16) between 1973 and 1990; (2) age 3 years to 60 years at injury; (3) admission to the hospital alive; and (4) death during the study period. Patients were separated into two groups: patients deceased during the initial hospital stay (in-hospital deaths, n = 408) and patients deceased after discharge (postdischarge deaths, n = 103). The survival of the PT victims was compared descriptively with age- and gender-matched data from the general population (GP). RESULTS: Causes of death in in-hospital deaths are head injury (37%), adult respiratory distress syndrome (14%), sepsis (11%), hemorrhagic shock (10%), pneumonia (9%), multiple organ failure (9%), and others (10%). Causes of death after discharge included cardiovascular diseases (23%), second major trauma (19%), neurologic diseases (16%), suicide (10%), malignancies (6%), and others (26%). The analysis of survival showed a higher mortality for PT compared with the GP group during the first year after the event (p < 0.05). Between 2 years and 10 years after the event, the annual mortality of the PT-group approximates the GP group. CONCLUSION: PT patients who die after discharge from the initial hospitalization show other causes of death than age-matched controls of the general population. Among these are second major trauma and suicide. Future studies should investigate whether certain social or psychologic factors might play a role.
AB - INTRODUCTION: The information about the long-term mortality and causes of death after multiple injuries is sparse. In general, most follow-up studies report on 1 year to 3 years maximum follow up. The current literature focuses on causes of death immediately after trauma or during the initial in-hospital stay. We report on long-term mortality and causes of death in patients with multiple injures up to 30 years after the initial injury. METHODS AND MATERIAL: We analyzed the causes of death using patient files, inquiries of patients' relatives, and death certificates. Inclusion criteria are (1) polytrauma (PT) (Injury Severity Score ≥16) between 1973 and 1990; (2) age 3 years to 60 years at injury; (3) admission to the hospital alive; and (4) death during the study period. Patients were separated into two groups: patients deceased during the initial hospital stay (in-hospital deaths, n = 408) and patients deceased after discharge (postdischarge deaths, n = 103). The survival of the PT victims was compared descriptively with age- and gender-matched data from the general population (GP). RESULTS: Causes of death in in-hospital deaths are head injury (37%), adult respiratory distress syndrome (14%), sepsis (11%), hemorrhagic shock (10%), pneumonia (9%), multiple organ failure (9%), and others (10%). Causes of death after discharge included cardiovascular diseases (23%), second major trauma (19%), neurologic diseases (16%), suicide (10%), malignancies (6%), and others (26%). The analysis of survival showed a higher mortality for PT compared with the GP group during the first year after the event (p < 0.05). Between 2 years and 10 years after the event, the annual mortality of the PT-group approximates the GP group. CONCLUSION: PT patients who die after discharge from the initial hospitalization show other causes of death than age-matched controls of the general population. Among these are second major trauma and suicide. Future studies should investigate whether certain social or psychologic factors might play a role.
KW - Cause of death
KW - Mortality
KW - Multiple injuries
KW - Outcome
KW - Polytrauma
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=67651040347&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67651040347&partnerID=8YFLogxK
U2 - 10.1097/TA.0b013e318197b97c
DO - 10.1097/TA.0b013e318197b97c
M3 - Article
C2 - 19359940
AN - SCOPUS:67651040347
VL - 66
SP - 1212
EP - 1217
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 4
ER -