Preventable prehospital trauma deaths in a Hellenic urban health region: an audit of prehospital trauma care.
OBJECTIVE
To identify preventable prehospital deaths, caused by trauma.


METHODS
Analysis of 82 trauma victims who were dead on arrival (DOA) into our hospital.


METHODS
General Hospital of Piraeus, Greece.


METHODS
Evaluation of the autopsy findings of 82 DOAs.


METHODS
Demographic, autopsy, and toxicology data, ICD9 codes, Abbreviated Injury Score (AIS)-90, Injury Severity Score (ISS)-body regions, central nervous system (CNS) deaths, non-CNS deaths, p values, and opinion of a clinical assessor.


RESULTS
The 29 (35.36%) DOAs had at least one AIS6 injury. Extracranial hemorrhage, airway, and breathing dysfunction were contributing factors of death of 27 "possibly preventable" CNS deaths, and the causes of death for the 20 non-CNS deaths. p value (0.5) indicated that 24 (29.26%) of the DOAs expected to survive. The clinical assessor characterized four (4.87%) as "definitely preventable" and 35 (42.65%) as "possibly preventable" deaths.


CONCLUSIONS
Upgrading of the emergency medical care service is required.
Papadopoulos
I N
IN
4th Surgical Department, University of Athens, General Hospital of Piraeus, Greece.
Bukis
D
D
Karalas
E
E
Katsaragakis
S
S
Stergiopoulos
S
S
Peros
G
G
Androulakis
G
G
D000007:Abdominal Injuries / Q000453:epidemiology; D000056:Accident Prevention; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001930:Brain Injuries / Q000453:epidemiology; D002490:Central Nervous System / Q000293:injuries; D004632:Emergency Medical Services / Q000592:standards*; D000431:Ethanol / Q000097:blood; D005260:Female; D006115:Greece / Q000453:epidemiology; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D019838:Neck Injuries; D011446:Prospective Studies; D013898:Thoracic Injuries / Q000453:epidemiology; D014505:Urban Population; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*
D000431:Ethanol