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 > or = 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.
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 > or = 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.
Authors: Brittany Mathias; Amber L Delmas; Tezcan Ozrazgat-Baslanti; Erin L Vanzant; Benjamin E Szpila; Alicia M Mohr; Frederick A Moore; Scott C Brakenridge; Babette A Brumback; Lyle L Moldawer; Philip A Efron Journal: Ann Surg Date: 2017-04 Impact factor: 12.969
Authors: Heena P Santry; Charles M Psoinos; Christopher J Wilbert; Julie M Flahive; Aimee R Kroll-Desrosiers; Timothy A Emhoff; Catarina I Kiefe Journal: J Crit Care Date: 2015-01-08 Impact factor: 3.425
Authors: Christian Kleber; Moritz T Giesecke; Michael Tsokos; Norbert P Haas; Klaus D Schaser; Poloczek Stefan; Claas T Buschmann Journal: World J Surg Date: 2012-09 Impact factor: 3.352
Authors: Claas T Buschmann; Patrick Gahr; Michael Tsokos; Wolfgang Ertel; Johannes K Fakler Journal: Scand J Trauma Resusc Emerg Med Date: 2010-10-26 Impact factor: 2.953
Authors: Dina C Nacionales; Benjamin Szpila; Ricardo Ungaro; M Cecilia Lopez; Jianyi Zhang; Lori F Gentile; Angela L Cuenca; Erin Vanzant; Brittany Mathias; Jeevan Jyot; Donevan Westerveld; Azra Bihorac; Anna Joseph; Alicia Mohr; Lizette V Duckworth; Frederick A Moore; Henry V Baker; Christiaan Leeuwenburgh; Lyle L Moldawer; Scott Brakenridge; Philip A Efron Journal: J Immunol Date: 2015-08-05 Impact factor: 5.422