Preventable deaths after head injury: a clinical audit of performance.
A retrospective trauma audit of 267 consecutive patients presenting to the resuscitation room of an accident and emergency department identified 107 (M = 0.73) patients with CNS predominant injuries in a period of 1 year. The mortality rate was 33 per cent. Application of the TRISS method indicated that 18 (51 per cent) of the 35 deaths (Z = 5.74, P less than 0.001) were mathematically unexpected; no unexpected survivors were identified. Subsequent peer review agreed that death was preventable in 11 cases. The peer panel suggested that the lack of an on-site neurosurgical service may have affected the outcome of this group of patients adversely.
Phair
I C
IC
Accident and Emergency Department, Leicester Royal Infirmary, UK.
Barton
D J
DJ
Allen
M J
MJ
Barnes
M R
MR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D004636:Emergency Service, Hospital / Q000592:standards*; D004739:England / Q000453:epidemiology; D017052:Hospital Mortality; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010380:Peer Review / Q000379:methods; D012189:Retrospective Studies