title: "Avoidable" deaths in two areas of Sweden - analysis of deaths in hospital after injury.
abstract: OBJECTIVE
  To describe causes of death and other characteristics of "avoidable" deaths in patients admitted to hospital after trauma, and estimate and analyse changes in the avoidable death rate during the years studied.
  
  
  METHODS
  Retrospective analysis of medico legal autopsy material.
  
  
  METHODS
  One northern and one western area in Sweden 1988-1996.
  
  
  METHODS
  335 cases who died in hospital after trauma.
  
  
  METHODS
  Avoidable death, defined as an Injury Severity Score (ISS) of 35 or less and Abbreviated Injury Scale (AIS) head of 4 or less and cause of death.
  
  
  RESULTS
  We found 70 avoidable deaths (21%). Among these, 15 (21%) died of head injuries, 17 (24%) of thoracic, abdominal, or pelvic injuries, and 38 (54%) of medical complications. The number of deaths after trauma decreased considerably from 1988-90 to 1994-96, but the proportion who died in hospital remained almost constant. The proportion of avoidable deaths decreased from 22% to 17%, mainly because the proportion of deaths from medical complications was halved.
  
  
  CONCLUSIONS
  The standard of Swedish in-hospital trauma care has improved, particularly with a reduction in post-traumatic complications. However, there is still room for improvement in the treatment of complications among elderly people.
authors.affiliation: Department of Surgery, Umeå University, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Boman
authors.forename: U
authors.initials: U
authors.lastname: Björnstig
authors.forename: A
authors.initials: A
authors.lastname: Hedelin
authors.forename: A
authors.initials: A
authors.lastname: Eriksson
mesh_terms: D000368:Aged; D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000401:mortality*