Preventable and potentially preventable deaths in severely injured elderly patients: a single-center retrospective data analysis of a German trauma center.

BACKGROUND: Due to widespread demographic changes, populations in industrial countries are ageing. A common tool for quality improvement of trauma care is the analysis of deaths in trauma patients. This study focuses on preventable or potentially preventable deaths, and on patterns of errors in severely injured elderly patients, a group that is under-represented in the literature.
METHODS: Data from a level 1 trauma center in Germany were analyzed for this study. A retrospective chart analysis was performed for all deceased patients older than 75 years with an Injury Severity Score greater than 15. Additionally, the data from the Trauma Registry of the German Society for Trauma Surgery were used. According to a Trauma Division Morbidity and Mortality conference, and after a review of all authors, deaths were classified as preventable, potentially preventable, and non-preventable.
RESULTS: Of the 2,304 patients admitted to the trauma room, 108 met the inclusion criteria. A total of 62 (57.41 %) patients died. Two deaths were declared as preventable deaths (3.23 %) and eight as potentially preventable (12.90 %). The most common preclinical error was associated with airway management. Hemorrhage control was the leading error in the clinical setting. Excessive fluid volume resuscitation was the second most common error detected.
CONCLUSION: The rate of preventable or potentially preventable deaths in severely injured elderly patients is similar to that reported for other age groups. Thus, most errors were human judgment errors or human treatment errors; therefore, education and training in the treatment of severely injured patients is extremely important.